Burden of Rotavirus in Medicaid Pediatric Populations

Learning Objectives for this Presentation:
-Define and understand the inpatient burden of rotavirus in the US
-Compare the inpatient burden of rotavirus in Medicaid populations to the one in the general public

Background:
Rotavirus is one of the most common causes of severe gastroenteritis in infants and young children. In the US, total annual societal costs of rotavirus sum to approximately $1 billion. Data on the burden of rotavirus in Medicaid populations prior to the introduction of the pentavalent human-bovine reassortant rotavirus vaccine in 2006 is not available. This type of data is crucial to evaluate potential benefits of national rotavirus immunization programs in Medicaid populations.

Objectives:
To estimate and compare the rate of hospitalizations due to rotavirus gastroenteritis in Medicaid and non-Medicaid children populations age 0-4 years.

Methods:
The Kid's Inpatient Database (KID) was used to estimate the number and rate of hospitalizations due to acute gastroenteritis and rotavirus among Medicaid and non-Medicaid children populations age 0-4 years in 2000 and 2003. KID is a national representative sample of 10% uncomplicated in-hospital births and 80% other pediatric discharges collected from participating states. Given that physicians generally do not test for rotavirus, the residual as well as the proportional methods were used to estimate the proportion of hospitalizations for acute gastroenteritis attributable to rotavirus.

Results:
Nearly half the hospitalizations due to rotavirus in the US involve Medicaid children enrollees. In 2003, the rates of hospitalizations for rotavirus ranged from 31.3 – 37.8 per 10000 children among Medicaid enrollees compared to 21.9 – 30.1 per 10,000 among non-Medicaid children. Similarly, in 2000, hospitalization rates ranged from 34.2 – 38.1 among Medicaid enrollees compared to 19.6 – 24.9 among non-Medicaid enrollees. These differences were statistically significant.

Conclusions:
While rotavirus gastroenteritis affects all socioeconomic groups, the rates of hospitalizations for children age 0-4 are estimated to be higher in the Medicaid population than in the non-Medicaid population.