1. Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial
- Author
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Amélie Gatin, Pascal Saunier, Simon Henry, Astrid Vabret, Christèle Gras-Le Guen, Vanessa Degas-Bussiere, Thanh-Van Trieu, Dominique Ploin, Luigi Titomanlio, Jacques Brouard, Isabelle Durand-Zaleski, Delphine Regnard, François Angoulvant, Géraldine Patteau, Jean-Paul Teglas, Abdelilah Tahir, Jean Bouyer, Valérie Soussan-Banini, Yves Marot, Henri Panjo, Philippe Minodier, B. Vrignaud, Philippe Babe, Thibault Butel, Ralph Epaud, Antoine Filipovic-Pierucci, Philippe Flahaut, Mathilde Delebarre, Karen Milcent, Xavier Bellettre, Oussama Charara, Isabelle Claudet, Pierrick Cros, Vincent Gajdos, François Dubos, Amélie Ryckewaert, Cyril Schweitzer, Pascale Micheau, Loïc de Pontual, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), AP-HP - Hôpital Antoine Béclère [Clamart], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Robert Debré, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Jean Verdier [AP-HP], Assistance Publique - Hôpitaux de Marseille (APHM), CHU Lille, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Ambroise Paré [AP-HP], Centre Hospitalier Sud Francilien, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Universitaire [Rennes], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Rouen, Normandie Université (NU), Centre Hospitalier de Fontainebleau, Hôpitaux Pédiatriques de Nice Lenval (CHU-Lenval), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Necker - Enfants Malades [AP-HP], Hôpital Robert Debré Paris, CHU Limoges, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier de Versailles André Mignot (CHV), and Centre Hospitalier le Vinatier [Bron]
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Epidemiology ,Total cost ,[SDV]Life Sciences [q-bio] ,law.invention ,law ,medicine ,Humans ,Child ,First episode ,business.industry ,Infant ,Asthma & early wheeze ,Emergency department ,medicine.disease ,Intensive care unit ,Economic evaluation ,Hospitalization ,Clinical trial ,Bronchiolitis ,Pediatrics, Perinatology and Child Health ,Cohort ,Emergency medicine ,France ,Emergency Service, Hospital ,business - Abstract
International audience; Introduction: Bronchiolitis is the leading cause of hospitalization for infants but its economic burden is not well documented. Our objective was to describe the clinical evolution and to assess the 1-month cost of a first episode of acute bronchiolitis presenting to the emergency department (ED).Methods: Our study was an epidemiologic analysis and a cost study of the cohort drawn from the clinical trial GUERANDE, conducted in 24 French pediatric EDs. Infants of 6 weeks to 12 months of age presenting at pediatric EDs with a first episode of bronchiolitis were eligible. The costs considered were collected from a societal viewpoint, according to the recommendations of the French National Health Authority.Results: A total of 777 infants were included with a median age of 4 months. A total of 57% were hospitalized during the month following the first consultation in the ED, including 28 (3.6%) in an intensive care unit. The mean length of stay was 4.2 days (SD = 3.7). The average time to relief of all symptoms was 13 days (SD = 7). Average total cost per patient was €1919 (95% confidence interval: 1756-2138) from a societal perspective, mostly due to hospitalization cost. The estimated annual cost of bronchiolitis in infants was evaluated to be between €160 and €273 million in France.Discussion: Bronchiolitis represent a high cost for the health care system and broadly for society, with hospitalizations costs being the main cost driver. Thus significant investments should be made to develop innovative therapies, to reduce the number of hospitalizations and length of stay.
- Published
- 2021