Abstract
BACKGROUND: Rotavirus infection is a leading cause of acute gastroenteritis in children aged < 5 years. However, few studies assessed the spillover effect on caregivers' health-related quality of life (HRQoL) and out-of-pocket costs associated with rotavirus gastroenteritis (RGE) in Taiwan. METHODS: This is a prospective, observational, survey-based study conducted in Northern Taiwan between March 2021-September 2023. Caregivers were interviewed during the RGE-hospitalization episode and after patient discharge. One caregiver per child aged ≤ 9 years with clinical presentation of a new RGE hospitalization was enrolled. Outcomes assessed included caregiver HRQoL, emotional state, impact on daily routine, healthcare resource utilization (HCRU), and direct and indirect costs. RESULTS: The mean age of inpatients was 3.03 years and 69.0% were male. Rotavirus genotype G3P[8] was detected in 61.2% of patients. Caregivers' mean age was 33.7 years, 79.3% were female, and 65.5% had monthly household income < NT$80,000. Caregivers reported significantly higher health state (EQ visual analog scale) after discharge (86.21) than during RGE hospitalization (74.48) (p = 0.049). Among the caregivers, 65.5% and 69.0% experienced disruptions in sleep and leisure activities, respectively. About 45% were worried about complications and 41.4% were concerned about their child's recovery. The total medical costs associated with hospitalization, reimbursed by National Health Insurance, averaged US$575.56. Additional out-of-pocket costs included US$82.51 for medical visits, US$44.95 for transportation, US$5.47 for medication, and US$90.41 for meals outside the home. The caregivers also reported taking an average of 0.12, 1.18, and 1.82 days of child/parental, paid, and unpaid leave, respectively. The estimated wage loss associated with the days not working was US$246.67. CONCLUSION: RGE poses a significant burden on caregivers' HRQoL, daily activities, and out-of-pocket costs. Interventions aimed at mitigating the spillover effects of RGE on caregivers are essential to improve family well-being. CLINICAL TRIAL NUMBER: Not applicable.