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
Thibault Butel
(1)
,
François Angoulvant
(2, 3)
,
Antoine Filipovic-Pierucci
(1)
,
Karen Milcent
(4)
,
Jean‐paul Teglas
(5)
,
Xavier Bellêttre
(6)
,
Isabelle Claudet
(7)
,
Christèle Gras-Le Guen
(8)
,
Loïc de Pontual
(9)
,
Philippe Minodier
(10)
,
François Dubos
(11)
,
Jacques Brouard
(12)
,
Valérie Soussan-Banini
(13)
,
Vanessa Degas-Bussiere
(14)
,
Amélie Gatin
(15)
,
Cyril Schweitzer
(15)
,
Ralph Epaud
(16)
,
Amélie Ryckewaert
(17)
,
Pierrick Cros
(18)
,
Yves Marot
(19)
,
Philippe Flahaut
(20)
,
Pascal Saunier
(21)
,
Philippe Babe
(22)
,
Géraldine Patteau
(23)
,
Mathilde Delebarre
(11)
,
Luigi Titomanlio
(24)
,
Bénédicte Vrignaud
(8)
,
Thanh‐van Trieu
(9)
,
Abdelilah Tahir
(25)
,
Delphine Regnard
(26)
,
Pascale Micheau
(7)
,
Oussama Charara
(27)
,
Simon Henry
(18)
,
Dominique Ploin
(28)
,
Henri Panjo
(5)
,
Astrid Vabret
(12)
,
Jean Bouyer
(5)
,
Isabelle Durand-Zaleski
(23)
,
Vincent Gajdos
(4, 5)
1
AP-HP -
Assistance publique - Hôpitaux de Paris (AP-HP)
2 HeKA - Health data- and model- driven Knowledge Acquisition
3 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
4 AP-HP - Hôpital Antoine Béclère [Clamart]
5 CESP - Centre de recherche en épidémiologie et santé des populations
6 Hôpital Robert Debré
7 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
9 Hôpital Jean Verdier [AP-HP]
10 APHM - Assistance Publique - Hôpitaux de Marseille
11 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
12 CHU Caen
13 Hôpital Ambroise Paré [AP-HP]
14 Centre Hospitalier Sud Francilien
15 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
16 CHIC - Centre Hospitalier Intercommunal de Créteil
17 Centre Hospitalier Universitaire [Rennes]
18 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
19 CHU Trousseau [Tours]
20 CHU Rouen
21 Centre Hospitalier de Fontainebleau
22 CHU-Lenval - Hôpitaux Pédiatriques de Nice Lenval
23 Hôpital Necker - Enfants Malades [AP-HP]
24 Hôpital Robert Debré Paris
25 CHU Limoges
26 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
27 CHV - Centre Hospitalier de Versailles André Mignot
28 Centre Hospitalier le Vinatier [Bron]
2 HeKA - Health data- and model- driven Knowledge Acquisition
3 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
4 AP-HP - Hôpital Antoine Béclère [Clamart]
5 CESP - Centre de recherche en épidémiologie et santé des populations
6 Hôpital Robert Debré
7 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
9 Hôpital Jean Verdier [AP-HP]
10 APHM - Assistance Publique - Hôpitaux de Marseille
11 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
12 CHU Caen
13 Hôpital Ambroise Paré [AP-HP]
14 Centre Hospitalier Sud Francilien
15 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
16 CHIC - Centre Hospitalier Intercommunal de Créteil
17 Centre Hospitalier Universitaire [Rennes]
18 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
19 CHU Trousseau [Tours]
20 CHU Rouen
21 Centre Hospitalier de Fontainebleau
22 CHU-Lenval - Hôpitaux Pédiatriques de Nice Lenval
23 Hôpital Necker - Enfants Malades [AP-HP]
24 Hôpital Robert Debré Paris
25 CHU Limoges
26 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
27 CHV - Centre Hospitalier de Versailles André Mignot
28 Centre Hospitalier le Vinatier [Bron]
Thibault Butel
- Fonction : Auteur
- PersonId : 1216052
- ORCID : 0000-0002-3983-4796
François Angoulvant
- Fonction : Auteur
- PersonId : 1076940
- IdHAL : francois-angoulvant
Cyril Schweitzer
- Fonction : Auteur
- PersonId : 1216053
- ORCID : 0000-0003-0895-774X
Ralph Epaud
- Fonction : Auteur
- PersonId : 756906
- ORCID : 0000-0003-3830-1039
- IdRef : 092124453
Jean Bouyer
- Fonction : Auteur
- PersonId : 182329
- IdHAL : jean-bouyer
- ORCID : 0000-0003-4861-0783
- IdRef : 055746632
Résumé
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.