Respiratory syncytial virus (RSV) hospitalization and discharge patterns am0ng adults in Ontario, Canada

Client: IQVIA Solutions Canada Inc.

Project ID: P2023-191/ 2024 0970 372 000

Research Question/Objectives: This study aims to understand the hospitalization and re-admission patterns, discharge types and locations, mortality, and direct healthcare costs in Ontario, Canada for adults 50 years and older hospitalized with Respiratory syncytial virus (RSV) compared to matched controls.

Objectives:

Primary objectives:

1. To estimate the seasonal incidence of RSV-associated hospitalizations (RSV-H) among patients 50 years and older in Ontario, Canada as identified through ICD-10-CA diagnosis codes during the 2010/11 – 2021/22 seasons.

2. To describe the baseline demographic and clinical characteristics for patients 50 years and older with RSV-H and for matched controls (i.e., 1) general population (i.e., patients not hospitalized with RSV), 2) flu (i.e., patients hospitalized with flu)) in Ontario, Canada during the 2010/11 – 2021/22 seasons.

3. To describe health care resource utilization (HCRU) (e.g., length of stay (LOS)) and step-up care (e.g., ICU admission, days in ICU, mechanical ventilation)) for patients 50 years and older with RSV-H and for matched controls (i.e., 1) general population, 2) flu) in Ontario, Canada in the one year after index during the 2010/11 – 2021/22 seasons.

4. To calculate the frequency of all-cause hospital re-admissions at intervals (e.g., 30-, 60-, and 90-days) post-discharge for patients 50 years and older with RSV-H and for matched controls (i.e., flu) in Ontario, Canada during the 2010/11 – 2021/22 seasons.

5. To describe the frequency of discharge to higher levels of care (e.g., longterm care (LTC), professional home care, etc.) for patients 50 years and older with RSV-H and for matched controls (i.e., flu) in Ontario, Canada during the 2010/11 – 2021/22 seasons.

6. To describe all-cause mortality among patients 50 years and older with RSV-H and for matched controls (i.e., 1) general population, 2) flu) in Ontario, Canada during the 2010/11 – 2021/22 seasons.

Secondary objectives:

1. To estimate the total direct healthcare costs (e.g., physician services, ED, hospitalizations, same-day surgery) in the one-year post-hospitalization during the 2010/11 – 2021/22 seasons for patients 50 years and older with RSV-H, and for matched controls (i.e., 1) general population, 2) flu)) in Ontario, Canada and if feasible, stratified by number of hospitalizations (e.g., first hospitalization vs re-admission).

2. To estimate the direct healthcare costs in the one-year post-hospitalization during the 2010/11 – 2021/22 seasons by type of discharge to higher levels of care (e.g., LTC costs, rehabilitation, and home care costs) for patients 50 years and older with RSV-H and for matched controls (i.e., flu) in Ontario, Canada.

Exploratory objectives:

1. If feasible, describe re-admissions due to exacerbations of previous conditions (e.g., chronic obstructive pulmonary disease (COPD), asthma, cardiovascular disease (CVD), diabetes and renal disease) and/or potential ongoing complications (e.g., pneumonia, bronchitis) following RSV-H during the 2010/11 – 2021/22 seasons in patients 50 years and older in Ontario, Canada.

2. If feasible, contextualize study results due to changes in RSV testing practices (e.g., shift to using multiplex respiratory virus PCR to test for multiple respiratory pathogens) in Ontario, Canada during the 2010/11 – 2021/22 seasons.

3. If feasible, examine changes in RSV-H patterns (i.e., incidence, LOS) in the pre-COVID-19 (September 1, 2010 to March 10, 2020) vs COVID-19 period (March 11, 2020 to May 5, 2023) and post-COVID-19 period (May 6, 2023 to August 31, 2023 or up until data availability) in Ontario, Canada

Results: In progress