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Emerg Med Australas. 2017 Jun;29(3):324-329. doi: 10.1111/1742-6723.12713. Epub 2016 Dec 22.

Economic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis.

Author information

1
Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
2
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
3
Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
4
Deakin Health Economics, Population Health SRC, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
5
Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.
6
School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
7
School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Western Australia, Australia.
8
Department of Emergency Medicine, Kidz First Hospital, Auckland, New Zealand.
9
Department of Emergency Medicine, Lady Cilento Hospital, Brisbane, Queensland, Australia.
10
Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia.
11
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
12
Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia.
13
Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
14
Liggins Institute, The University of Auckland, Auckland, New Zealand.
15
Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia.
16
Department of Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.

Abstract

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites.

KEYWORDS:

bronchiolitis; child; economic evaluation; hydration; intravenous; nasogastric

PMID:
28004493
DOI:
10.1111/1742-6723.12713
[Indexed for MEDLINE]

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