Healthcare Utilization and Economic Burden of RSV Infections Among Children Under 5 Years in Saudi Arabia: A MNGHA Facilities Analysis

Background: RSV infections impose a substantial burden that goes beyond their clinical effects, significantly impacting healthcare resource consumption, existing data indicates a substantial healthcare and economic burden in Saudi Arabia, with early diagnosis costs estimated at $16,692 per patient.

Objective: to assess healthcare utilization and associated costs of RSV infection among children under 5 years of age

Methods: Retrospective cohort study of children aged ≤5 years with documented RSV testing• Study period: Jan 1, 2018 – Dec 31, 2023• Conducted across MNGHA facilities in KSA• Five hospitals (Riyadh, Jeddah, Al-Ahsa, Al-Madinah, Dammam)• 71 affiliated PHCs• Variables assessed: age, hospital & ICU admissions, LOS• Direct healthcare costs estimated from ICU, ward, ED/OPD, diagnostic and treatment-related expenses

Number of laboratory-confirmed RSV cases across different age groups

34,957 children were analyzed, including 7,371 RSV-positive and 27,586 RSV-negative cases
Median age wfor RSV-negative children
RSV-positive cases had significantly higher hospital admission rates (63.2% vs. 26.2%) as 10.0 months for RSV-positive children vs 12.3 months

The majority of RSV-positive children were previously healthy (95.3%) ,A small proportion had underlying comorbidities (4.7%)
Infants aged <12 months contributed to a substantial proportion of laboratory-confirmed RSV cases

Proportional distribution of laboratory-confirmed RSV cases across the study years

infants <12 months contributed to a substantial proportion of cases, with peak incidence in 2022

Proportion of children with laboratory-confirmed RSV infection by associated comorbidities

The majority of RSV-positive children were previously healthy (95.3%)
A small proportion had one or more comorbidities (4.7%)
Reported comorbidities included congenital heart disease, congenital anomalies, and chronic illnesses

Table 1. Estimated direct medical cost (SAR) distributed by year of diagnosis

Variables	Y2018 (n=1037)	Y2019 (n=1248)	Y2020 (n=699)	Y2021 (n=794)	Y2022 (n=2590)	Y2023 (n=1003)
ICU admission cost	171,405	122,850	115,128	957,528	1,507,838	565,208
Ward admission cost	357,675	502,775	186,250	2,730,163	8,309,600	1,924,950
Emergency Department/Outpatient visit cost	414,800	499,200	279,600	317,600	1,036,000	401,200
Diagnostic and Treatment cost	241,300	330,600	149,150	684,000	2,393,050	624,150
Overall direct medical cost	1,185,180	1,455,425	730,128	4,689,291	13,246,488	3,515,508
Average direct medical cost per case	1142.89	1166.21	1044.53	5905.91	5114.47	3504.99

Table 1 – Key Findings (By Year)

Overall direct medical costs increased over time, peaking in 2022 at 13.25 million SAR.
Costs were markedly higher in 2021 (4.69 million SAR) and declined in 2023 (3.52 million SAR).

Table 2. Estimated direct medical cost (SAR) distributed by age at diagnosis

Variables	< 1 month (n=373)	1-2 months (n= 1226)	3-5 months (n= 1100)	6-11 months (n=1355)	12-17 months (n=960)	18-23 months (n=547)
ICU admission cost	514,800	1,105,650	234,000	409,617	587,087	117,000
Ward admission cost	787,050	2,280,163	1,637,700	1,932,000	1,494,588	720,300
Emergency Department/Outpatient visit cost	149,200	490,400	440,000	542,000	384,000	218,800
Diagnostic and Treatment cost	225,150	732,450	618,450	781,850	575,700	329,650
Overall direct medical cost	1,676,200	4,608,663	2,930,150	3,665,467	3,041,375	1,385,750
Average direct medical cost per case	4493.83	3759.11	2663.77	2705.14	3168.10	2533.36

Table 2 – Key Findings (By Age)

The highest direct medical cost was observed among infants aged 1–2 months (4.61 million SAR).
High costs were also reported in infants aged 6–11 months (3.67 million SAR) and 3–5 months (2.93 million SAR).
Infants aged 0–12 months incurred higher costs compared with older age groups.

Farahat F, Alshanrani M, Alsager K, Alzunitan M, Alsacedi A, Alahmadi M, et al. Healthcare utilization and economic burden of RSV infections among children under 5 years in Saudi Arabia: A MNGHA facilities analysis. Presented at: KSA ID Week; 2025; Saudi Arabia.
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