Respiratory syncytial virus-associated hospital admissions by deprivation levels among children and adults in Scotland

Background Socioeconomic deprivation may predispose individuals to respiratory tract infections (RTI). We aimed to estimate the number and rate of RSV-associated hospitalisations by socioeconomic status using the Scottish Index of Multiple Deprivation (SIMD). Methods Using national routine healthcare records and virological surveillance from 2010-2016, we used a time-series linear regression model and a direct measurement based on ICD-10 coded diagnoses to estimate RSV-associated hospitalisations by SIMD level and age and compared to influenza-associated hospitalisations. Results Using the model-based approach, we estimated an annual average rate per 1000 of 0.76 (95%CI: 0.43-0.90) for individuals of all ages in the least deprived group (5 th quintile of SIMD) to 1.51 (1.03-1.79) for the most deprived group (1 st quintile). Compared with the least deprived group, we estimated that the rate ratio (RR) was 1.96 (95%CI: 1.23-3.25), 1.60 (1.0- 2.66), 1.35 (0.85-2.25), and 1.12 (0.7-1.85) in the 1 st to 4 th quintile. The pattern of RSV- associated RTI hospitalisation rates variation with SIMD was most pronounced in children aged 2 years and below. The ICD-10 direct measurement approach provided much lower rates than the model-based approach but yielded similar RR estimates between SIMD groups. Conclusion Higher RSV hospitalisation rates are seen in the Scottish population of higher deprived levels. The differences between deprivation levels are most pronounced in infants and young children.