Use of state hospital discharge data to assess the morbidity from rotavirus diarrhea and to monitor the impact of a rotavirus immunization program: Apilot study in Connecticut

Objectives. Now that rotavirus vaccines have been licensed and recommended for routine immunization of US infants, there is an urgent need for data to assess the morbidity from rotavirus diarrhea and to monitor the impact of a rotavirus immunization program. In a pilot study, we have assessed the us efulness of state hospital discharge data on diarrhea in children to provid e this information by examining data from Connecticut. Design. Retrospective analysis of discharge records from acute care, nongov ernmental hospitals in Connecticut. Patients. Children 1 month through 4 years of age with a diarrhea-associate d diagnosis listed on the discharge record. Setting. Connecticut, 1987 through 1996. Results. During the 10-year study period, a total of 11 324 diarrhea-associ ated hospitalizations (49.4 hospitalizations per 10 000 children) were repo rted. Diarrhea-associated hospitalizations peaked during February through A pril, especially among children 4 to 35 months of age. The seasonality and age distribution of diarrhea-associated hospitalizations of presumed noninf ectious and viral etiologies resembled those of rotavirus-associated hospit alizations. During 1993 to 1996, rotavirus was coded for 10.4% of diarrhea- associated hospitalizations increasing from 8.6% in 1993 to 14.7% in 1996. The unadjusted median cost of a diarrhea-associated hospitalization during 1987 to 1996 and 1993 to 1996 was $1941 and $2428, respectively. Conclusions. Diarrhea causes substantial morbidity in children from Connect icut. The winter seasonal peak of diarrhea-associated hospitalizations in c hildren 4 to 35 months of age coinciding with the peak of rotavirus-specifi c hospitalizations suggests that rotavirus is an important contributor to t he overall morbidity. Although our findings suggest incomplete coding of ro tavirus cases, state hospital discharge data should provide sensitive and t imely information to monitor the impact of a rotavirus immunization program in Connecticut.