Primary Objective: -Estimate the hospital-associated healthcare resource use (HCRU), and associated costs, of RSV infection in children in comparison to the non-RSV control cohort (general population) and patients with rhinovirus infection. Secondary Objectives: * Describe demographic and clinical patient characteristics of RSV infected children. * Estimate and compare the incidence of RSV infection and acute respiratory infections (ARIs) in children. * Estimate the mortality associated with RSV infection in children. * Estimate the social economic burden of RSV infection in children in relation to parents staying home from work to care for their sick child (VAB leave) in comparison to non-RSV control cohort (i.e. parents to children in the general population). * Estimate the net days with VAB leave and the compensation disbursed (temporary parental benefit) associated with RSV infection in children. * Estimate the indirect costs that can be attributed to VAB leave. * Examine the medium- and long-term complications associated with an RSV diagnosis in children in comparison to the non-RSV control chart (general population) and patients with rhinovirus infection. * Examine and describe risk factors associated with an RSV infection in children * Estimate the healthcare resource use (HCRU), and associated costs, of RSV infection in children, for a subset of patients where primary care data is available, in comparison to the non-RSV control cohort (general population).
The overall study period will be between July 1st 2001 and to latest available date (likely June 30th 2022). Patients will be identified for inclusion in the study population between July 1st 2006 and June 30th 2021. Patients will be followed from time of inclusion until end of the study period or until death. All patients will have an index date corresponding to the date of diagnosis of incident infection in primary and/or hospital care during the identification period. An incident infection is defined as the occurrence of infections more than 30 (\>30) days apart. This implies that a patient can have more than one index date during the study period. Patients that are included in both the RSV cohort and the regional primary care RSV cohort may have two different index dates for the same incident infection, depending on the objective. This is if a patient is first treated in primary care and then hospitalized. The index date is defined differently for the two cohorts, as the first diagnosis in hospital care for the RSV cohort and first diagnosis in primary care OR hospital care for the regional primary care cohort. The non-RSV controls will have the same index date as their matched RSV patient. The look-back period will be used to inform baseline characteristics as well as patients' medical and diagnosis history. All patients will have possible look-back from birth for information on the patient's hospital care history and from 2005 for information on the patient's prescribed drugs history. The individual look-back and follow-up will depend on the time of inclusion in the study population as well as age at inclusion.
Study Type
OBSERVATIONAL
Enrollment
1,100,000
Short-term healthcare: Number of specialist outpatient visits
Number of RSV specialist outpatient hospital visits during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Number of hospitalizations
Number of hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Length of hospitalizations
The length of hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Number of Intensive Care Unit (ICU) hospitalizations
Number of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Length of ICU hospitalizations
The length of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Number of RSV-related medical/surgical procedures
Number of RSV-related medical/surgical procedures during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: Number of dispensed prescriptions of RSV-related medications
Number of dispensed prescriptions of RSV-related medications during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: The costs of direct medical (in- and outpatient care)
Direct medical (in- and outpatient care) costs related to RSV infection
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Short-term healthcare: The costs of RSV-related medications
The costs of dispensed prescriptions of RSV-related medications based on pharmacy retail price
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Medium-term healthcare: Number of specialist outpatient visits
Number of RSV specialist outpatient hospital visits during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Number of hospitalizations
Number of hospitalizations/stays related to RSV during follow up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Length of hospitalizations
The length of hospitalizations/stays related to RSV during follow up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Number of Intensive Care Unit (ICU) hospitalizations
Number of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Length of ICU hospitalizations
The length of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Number of RSV-related medical/surgical procedures
Number of RSV-related medical/surgical procedures during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: Number of dispensed prescriptions of RSV-related medications
Number of dispensed prescriptions of RSV-related medications during follow-up
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: The costs of direct medical (in- and outpatient care)
Direct medical (in- and outpatient care) costs related to RSV infection
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Medium-term healthcare: The costs of RSV-related medications
The costs of dispensed prescriptions of RSV-related medications based on pharmacy retail price
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Patient characteristics
Age at diagnosis, sex distribution, region of residence, birth weight, birth height, gestational age, mothers age at birth, high-risk conditions, parent's education, parent's income, household status
Time frame: Analysis period: July 1st 2006 - June 30th 2021 Reporting period: at index date or during look-back period
Incidence of RSV/ARIs
Incidence of RSV/ARI per 100,000 population
Time frame: Analysis period: July 1st 2006 - June 30th 2021 Reporting period: by respiratory years
Number of laboratory-confirmed RSV cases with RSV diagnosis
Number of laboratory confirmed RSV cases with RSV diagnosis code (ICD-10)
Time frame: Analysis period: July 1st 2006 - June 30th 2021 Reporting period: at index date or during look-back period
Number of laboratory-confirmed RSV cases with no RSV diagnosis
Number of laboratory confirmed RSV cases with no RSV diagnosis code (ICD-10)
Time frame: Analysis period: July 1st 2006 - June 30th 2021Reporting period: at index date or during look-back period
Number of diagnosed RSV cases with no RSV laboratory tests conducted
Number of diagnosed RSV cases (ICD-10) with no laboratory test conducted
Time frame: Analysis period: July 1st 2006 - June 30th 2021 Reporting period: at index date or during look-back period
Mortality
All-cause 30-day death from index date
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 30 days from index date
Socioeconomic burden: Net days of VAB leave
Net days of temporary parental leave (VAB) during follow-up period due to child with RSV diagnosis
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
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Socioeconomic burden: Net VAB leave benefit
Net temporary parental leave (VAB) benefit during follow-up period due to child with RSV diagnosis
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Socioeconomic burden: Indirect costs of VAB leave due to RSV
Productivity loss due to RSV-related temporary parental leave during follow-up period, calculated by human capital method and average wage
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: 12 months from (first) index date
Proportion of patients that develop respiratory complications (ICD-10 codes)
Proportion of patients that develop respiratory complications (ICD-10 codes)
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: per year during 5 years from index date
Incidence of RSV per 1000 person-years
Incidence of RSV per 1000 person-years in RSV, non-RSV control cohorts and rhinovirus cohorts
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: per year during 5 years from index date
Incidence rate ratios (IRR)
Incidence rate ratios (IRR) in RSV, non-RSV control and rhinovirus cohorts
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: per year during 5 years from index date
Hazard ratios (HR)
Hazard ratios (HR) in RSV, non-RSV control and rhinovirus cohorts
Time frame: Analysis period: July 1st 2006 - July 31st 2021 Reporting period: per year during 5 years from index date
Estimation of hazard ratio of each risk factor on being diagnosed with RSV
A Cox proportional hazards regression model will be used to estimate the hazard ratio of each risk factor on being diagnosed with RSV. Predictors for RSV diagnosis presented as hazard ratios, including premature birth, high-risk conditions, APGAR, seasonality, mother's age at birth, number of children in household, birth order, parent's education, parent's income, household status, maternal smoking, mother's BMI
Time frame: Analysis period: July 1st 2006 - July 31st 2021Reporting period: look back period
Primary Care: Number of primary care contacts
Number of primary care contacts during follow-up period
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Number of specialized outpatient care visits
Number of specialized outpatient care visits during follow-up period
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Number of hospitalizations
Number of hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Length of hospitalizations
Length of hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Number of ICU hospitalizations
Number of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Length of ICU hospitalizations
Length of ICU hospitalizations/stays related to RSV during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Number of RSV-related medical/surgical procedures
Number of RSV-related medical/surgical procedures during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: Number of dispensed prescriptions of RSV-related medications
Number of dispensed prescriptions of RSV-related medications during follow-up
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: The costs of direct medical (in- and outpatient care)
Direct medical (in- and outpatient care) costs related to RSV infection
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date
Primary Care: The costs of RSV-related medications
The costs of dispensed prescriptions of RSV-related medications based on pharmacy retail price
Time frame: Analysis period: Date of first available data - July 31st 2021 Reporting period: 30 days from index date