Time and out-of-pocket costs associated with respiratory syncytial virus hospitalization of infants

Objective: The objective of this study was to quantify time spent plus out-of-pocket costs associated with confirmed respiratory syncytial virus (RSV) hospitalization of infants not prophylaxed against RSV. Methods: A prospective survey was carried out at multiple tertiary care hospitals in the United States. Patients: The patients consisted of a consecutive sample of infants <12 months, born between 33 and 35 weeks of gestation. One site also enrolled full-term infants hospitalized with confirmed RSV. Daily patient census identified eligible patients. Consenting caregivers of eligible subjects (n = 84, 1 refusal) were interviewed on discharge day and by telephone ∼30 days following discharge regarding time and out-of-pocket costs due to RSV. Results: Total average out of pocket expenses were $643.69 (range $21-$16,867; SD $2,403) for premature and $214.42 (range $6-$827; SD $218) (P = .0158) for full-term subjects. Total average economic burden per admission was $4517.07 for premature and $2135.30 for full-term infants, including the value of lost productivity but excluding inpatient hospital and physician bills and lost income. Premature infants (n = 48) had longer hospital stays (mean 6.9 days; SD 7.5 vs. 3.4 days; SD 2.6 days) (P = .001) with an associated mean total time spent by up to 5 adults of 281.7 hours (range 25-2819.7 hours; SD 465.8 hours) versus a mean of 139.7 hours (range 31.8-561.3 hours; SD 118.1 hours) for term infants (P = .109). Time and out-of-pocket costs continued after discharge. Conclusions: RSV hospitalization of infants is associated with substantial, previously unmeasured time and monetary losses. These losses continued following discharge. The economic burden on families and society appears heavier for infants born at 33 to 35 weeks of gestation than for full-term infants.