Abstract Title
Health care costs associated with norovirus in adults, Veterans Health Administration 2010 – 2024
Presenter
Jordan Cates, Centers for Disease Control and Prevention
Co-Author(s)
Richard E. Nelson2,3, Ying Suo3, Umesh D. Parashar1, Cynthia Lucero-Obusan4, Mark Holodniy4,5, Sara A. Mirza1. 1Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA, 2Veterans Affairs (VA) Salt Lake City's Informatics, Decision-Enhancement, and Analytic Sciences Center, Salt Lake City, Utah, USA, 3Division of Epidemiology, University of Utah, Salt Lake City, Utah, USA, 4Public Health National Program Office, Department of Veterans Affairs, Palo Alto, CA, USA and Washington, DC, USA, 5Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA USA
Abstract Category
Epidemology
Abstract
Background: Older adults are a potential target group for future norovirus vaccination efforts and more data is needed on the economic burden among this population. We quantified the outpatient, emergency department (ED), and inpatient health care costs associated with norovirus episodes among Veterans aged ≥18 years seeking care within the Veterans Health Administration (VHA) between January 2010 and December 2024.
Methods: Health care cost data were obtained from the VA Managerial Cost Account system for all encounters or admission within two days of a laboratory-confirmed norovirus-positive episode identified through the VHA electronic health record database. Costs were adjusted for inflation to 2024 US dollars. Costs were extrapolated to annual norovirus episodes with and without laboratory confirmation in the VHA.
Results: A total of 7768 norovirus episodes were included from 7520 patients with a median age of 62 years and median Charlson comorbidity index (CCI) of 1. There were 3520 outpatient, 2018 ED, and 2230 inpatient norovirus episodes with median (interquartile range) costs of $640 ($207–$1291), $2203 ($1596–$2989), and $14 083 ($8045–$26 672), respectively. Median inpatient costs were higher among those with significant comorbidities ($12 134, $14 928, and $18 517 among those with CCI of 1–2, 3–4, and ≥5, respectively) than those with a zero CCI ($9408; P<.0001). The extrapolated annual cost to the VHA was approximately $27 million.
Conclusions: These findings highlight the substantial economic burden associated with norovirus in the VHA and suggest potential cost savings of developing targeted interventions, such as vaccines and antivirals, for this population.
Methods: Health care cost data were obtained from the VA Managerial Cost Account system for all encounters or admission within two days of a laboratory-confirmed norovirus-positive episode identified through the VHA electronic health record database. Costs were adjusted for inflation to 2024 US dollars. Costs were extrapolated to annual norovirus episodes with and without laboratory confirmation in the VHA.
Results: A total of 7768 norovirus episodes were included from 7520 patients with a median age of 62 years and median Charlson comorbidity index (CCI) of 1. There were 3520 outpatient, 2018 ED, and 2230 inpatient norovirus episodes with median (interquartile range) costs of $640 ($207–$1291), $2203 ($1596–$2989), and $14 083 ($8045–$26 672), respectively. Median inpatient costs were higher among those with significant comorbidities ($12 134, $14 928, and $18 517 among those with CCI of 1–2, 3–4, and ≥5, respectively) than those with a zero CCI ($9408; P<.0001). The extrapolated annual cost to the VHA was approximately $27 million.
Conclusions: These findings highlight the substantial economic burden associated with norovirus in the VHA and suggest potential cost savings of developing targeted interventions, such as vaccines and antivirals, for this population.