RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

Respiratory syncytial virus (RSV) infection is associated with chronic respiratory morbidity in infants born very prematurely. Our aims were to determine if infants born moderately prematurely (32–35 weeks of gestation) who had had an RSV hospitalisation, compared to those who had not, had greater healthcare utilisation and related cost of care in the first 2 years. Two thousand and sixty-six eligible infants’ records were examined to identify three groups: 20 infants admitted for an RSV lower respiratory tract infection (RSV), 30 admitted for another respiratory problem (other respiratory) and 108 admitted for a non-respiratory problem/never admitted (non-respiratory). Healthcare utilisation was assessed by examining hospital and general practitioner records and cost of care calculated using the National Scheme of Reference costs and the British National Formulary prices. The mean cost of care in the RSV group (£12,505) was greater than the non-respiratory (£1,178) (95% CI for difference £5,015 to £17,639, p = 0.002) and the other respiratory (£3,356) groups (95% CI for difference £2,963 to £15,606, p < 0.001). The adjusted mean differences in the cost of care were £11,186 between the RSV and non-respiratory groups (95% CI £4,763 to £17,609) and £9,076 (95% CI £2,515 to £15,637) between the RSV and the other respiratory groups. Forty-two of 2,066 eligible infants had an RSV hospitalisation (2%); thus, assuming prophylaxis would reduce the hospitalisation rate by 50%, the number needed to treat was 98. In conclusion, RSV hospitalisation in moderately prematurely born infants is associated with increased health-related cost of care. Nevertheless, if RSV prophylaxis is to be cost-effective, a high risk group of moderately prematurely born infants needs to be identified.