OBJECTIVES: Hospitalizations due to respiratory syncytial virus (RSV) increased following the COVID-19 pandemic, highlighting the need to understand their economic burden on the healthcare system.

METHODS: Provincial administrative healthcare data at ICES, which captures healthcare encounters within Ontario’s publicly funded healthcare system, were used to identify patients aged ≤17 years who were hospitalized with RSV between July 1^st, 2010 and March 31^st, 2023, and describe the direct costs of individual RSV hospitalizations. Hospitalizations occurring within 30 days were considered a single hospitalization. Costs were standardized to 2021 Canadian dollars and annual outcomes reported from July 1^st to June 30^th of the next year.

RESULTS: Overall, 23,930 RSV hospitalizations were reported (annual range: 1,356 –4,298). Children <12 months accounted for 66% of all hospitalizations, of which >75% occurred in those <6 months. Annual costs were consistent over the study period, with a median (IQR) of $5,070 ($4,486–$6,742) per hospitalization. Those hospitalized at <1 month old incurred the highest costs, with a median (IQR) of $6,931 ($6,088–$11,408). These children also had the longest median length of hospital stay (108 hours) compared with the overall cohort (median: 69 hours). Overall, 12% of patients were admitted to the intensive care unit (ICU) for a median duration of 87 hours, incurring a median (IQR) hospitalization cost of $12,042 ($6,836-$24,685) compared to those with no ICU stay (median [IQR]: $4,945 [$4,429-$6,091]). Proportionally more patients hospitalized at <4 months old (16%) or 5-17 years old (22%) had an ICU stay. Overall, the total annual cost of RSV hospitalizations were CAD$12–16 million during 2010-11 to 2021-22, and more than doubled to $38 million in 2022-23 due to the rise in hospitalized cases.

CONCLUSIONS: The substantial healthcare costs of by RSV hospitalizations underscores the importance of preventative measures to mitigate this burden.