{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:22:28Z","timestamp":1770816148375,"version":"3.50.1"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chair","doi-asserted-by":"crossref","award":["CRC-950-232429"],"award-info":[{"award-number":["CRC-950-232429"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000241","name":"Physicians' Services Incorporated Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"name":"IMS Brogan Inc."}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>To determine 1-year attributable healthcare costs of bronchiolitis.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Using a population-based matched cohort and incidence-based cost analysis approach, we identified infants &lt;12 months old diagnosed in an emergency department (ED) or hospitalized with bronchiolitis between April 1, 2003 and March 31, 2014. We propensity-score matched infants with and without bronchiolitis on sex, age, income quintile, rurality, co-morbidities, gestational weeks, small-for-gestational-age status and pre-index healthcare cost deciles. We calculated mean attributable 1-year costs using a generalized estimating equation model and stratified costs by age, sex, income quintile, rurality, co-morbidities and prematurity.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>We identified 58,375 infants with bronchiolitis (mean age 154\u00b195 days, 61.3% males, 4.2% with comorbidities). Total 1-year mean bronchiolitis-attributable costs were $4,313 per patient (95%CI: $4,148\u20134,477), with $2,847 (95%CI: $2,712\u20132,982) spent on hospitalizations, $610 (95%CI: $594\u2013627) on physician services, $562 (95%CI: $556\u2013567)] on ED visits, $259 (95%CI: $222\u2013297) on other healthcare costs and $35 ($27\u201342) on drugs. Attributable bronchiolitis costs were $2,765 (95%CI: $2735\u20132,794) vs $111 (95%CI: $102\u2013121) in the initial 10 days post index date, $4,695 (95%CI: $4,589\u20134,800) vs $910 (95%CI: $847\u2013973) in the initial 180 days and $1,158 (95%CI: $1,104\u20131213) vs $639 (95%CI: $599\u2013679) during days 181\u2013360.<\/jats:p><jats:p>Mean 1-year bronchiolitis costs were higher in infants &lt;3 months old [$5,536 (95%CI: $5,216\u20135,856)], those with co-morbidities [$17,530 (95%CI: $14,683\u201320,377)] and with low birthweight [$5,509 (95%CI: $4,927\u20136,091)].<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Compared to no bronchiolitis, bronchiolitis incurs five-time and two-time higher healthcare costs within the initial and subsequent six-months, respectively. Most expenses occur in the initial 10 days and relate to hospitalization.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0260809","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T19:54:09Z","timestamp":1638474849000},"page":"e0260809","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Healthcare cost attributable to bronchiolitis: A population-based cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2128-9133","authenticated-orcid":true,"given":"Beate","family":"Sander","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaron","family":"Finkelstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1114-1645","authenticated-orcid":true,"given":"Chenthila","family":"Nagamuthu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Graves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren C.","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey C.","family":"Kwong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Schuh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"pone.0260809.ref001","doi-asserted-by":"crossref","first-page":"e1474","DOI":"10.1542\/peds.2014-2742","article-title":"Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis","volume":"134","author":"SL Ralston","year":"2014","journal-title":"Pediatrics"},{"key":"pone.0260809.ref002","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1542\/peds.2007-1392","article-title":"Infectious Disease Hospitalizations Among Infants in the United States","volume":"121","author":"KL Yorita","year":"2008","journal-title":"Pediatrics"},{"key":"pone.0260809.ref003","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/jpc.14104","article-title":"Australasian bronchiolitis guideline.","volume":"55","author":"S O\u2019Brien","year":"2019","journal-title":"J Paediatr Child Health"},{"key":"pone.0260809.ref004","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/apa.12671","article-title":"Diagnosis and treatment of bronchiolitis in Finnish and Swedish children\u2019s hospitals","volume":"103","author":"M Mecklin","year":"2014","journal-title":"Acta Paediatr"},{"key":"pone.0260809.ref005","volume-title":"Bronchiolitis in children | Quality standards (QS122)","author":"NICE","year":"2016"},{"key":"pone.0260809.ref006","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1136\/thx.2007.094706","article-title":"Management of acute bronchiolitis: can evidence based guidelines alter clinical practice?","volume":"63","author":"Swiss Paediatric Respiratory Research Group","year":"2008","journal-title":"Thorax"},{"key":"pone.0260809.ref007","first-page":"6","article-title":"Health for Kids Guideline Development Group. 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