Oakley Ed, Carter Rob, Murphy Bridie, Borland Meredith, Neutze Jocelyn, Acworth Jason, Krieser David, Dalziel Stuart, Davidson Andrew, Donath Susan, Jachno Kim, South Mike, Babl Franz E
Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Emerg Med Australas. 2017 Jun;29(3):324-329. doi: 10.1111/1742-6723.12713. Epub 2016 Dec 22.
Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration (IVH) was more cost-effective than nasogastric hydration (NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2-12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis.
Cost data collections included hospital and intervention-specific costs. The economic analysis was reduced to a cost-minimisation study, focusing on intervention-specific costs of IVH versus NGH, as length of stay was equal between groups. All analyses are reported as intention to treat.
Intervention costs were greater for IVH than NGH ($113 vs $74; cost difference of $39 per child). The intervention-specific cost advantage to NGH was robust to inter-site variation in unit prices and treatment activity.
Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites.
细支气管炎是婴儿最常见的下呼吸道感染,也是住院的主要原因。作为一项对759名(年龄在2至12个月之间)因临床诊断为细支气管炎而住院且需要非口服补液的婴儿进行的随机试验的计划二次经济分析,我们旨在评估静脉补液(IVH)是否比鼻胃管补液(NGH)更具成本效益。澳大利亚没有成本数据可帮助临床医生围绕细支气管炎的干预措施进行决策。
成本数据收集包括医院和特定干预措施的成本。由于两组住院时间相同,经济分析简化为成本最小化研究,重点关注IVH与NGH的特定干预措施成本。所有分析均按意向性分析报告。
IVH的干预成本高于NGH(113美元对74美元;每个儿童的成本差异为39美元)。NGH在特定干预措施方面的成本优势在各地点单价和治疗活动的差异中具有稳健性。
特定干预措施成本占细支气管炎住院总成本的比例不到10%;在所有地点,NGH都有少量成本节省。