Young children hospitalized for flu associated with higher costs and higher risk illness

The high costs of hospitalizing young children for influenza creates a significant economic burden in the United States, underscoring the importance of preventive flu shots for children and the people with whom they have regular contact, according to research led by Cincinnati Children's Hospital Medical Center and presented May 4 at the Pediatric Academic Society annual meeting in Honolulu, Hawaii.

After analyzing data in three U.S. cities over the course of three flu seasons (2003-2006), the researchers found that 90 percent of the highest-cost hospitalizations for children were linked to influenza, or flu with a co-infection of the respiratory tract. Children with the highest-cost visits were more likely to have high-risk conditions, emphasizing the importance of having these children immunized, said Gerry Fairbrother, Ph.D., a researcher in the Center for Clinical Effectiveness and Health Care Policy at Cincinnati Children's and senior author of the study.

Contributing most to the highest-cost hospitalizations were stays in the intensive care unit (ICU), with 65 percent of high-cost visits requiring ICU stays. Fifty-nine percent of children hospitalized for flu who also had high risk conditions spent time in the ICU, compared to 23 percent of children without high-risk conditions.

"Our study emphasizes the importance of ensuring that children and people they are in regular contact with be immunized for flu. It's vital to protect their health and to avoid the high costs of hospitalizations that are preventable," said Mary Staat, M.D., Ph.D., a physician and researcher in the Division of Infectious Diseases at Cincinnati Children's and study co-author.

In the study, researchers identified children under the age of 5 years who were hospitalized with influenza between 2003 and 2006. Identification came through active population-based acute respiratory surveillance programs in Hamilton County, Ohio, Monroe County, N.Y., and Davidson County, Tenn. Direct medical costs for hospital visits were obtained through respective accounting databases. In cases where children fell among the top 10 percent for the cost of hospitalization, the researchers reviewed medical records to identify factors driving those costs and to determine if they were related to the influenza. The researchers identified 199 flu-related hospitalizations involving children with an average age of 12 months. The average cost of hospitalization per patient was $5,448.

In addition to Cincinnati Children's, the study included researchers from the School of Medicine, Vanderbilt University, Nashville, Tenn.; School of Medicine and Dentistry, University of Rochester, Rochester, N.Y., and the New Vaccine Surveillance Network. The study was funded by the U.S. Centers for Disease Control and Prevention.

The PAS meeting is the largest international meeting focused on research in child health. It is sponsored by the American Academy of Pediatrics, the American Pediatric Society, the Society for Pediatric Research, and the Ambulatory Pediatric Association.

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