Carlos E Rodriguez-Martinez1,2, Monica P Sossa-Briceño3, Jose A Castro-Rodriguez4. 1. Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia. 2. Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia. 3. Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia. 4. Division of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Abstract
RATIONALE, AIMS, AND OBJECTIVES: The aim of the present study was to determine the cost-effectiveness of the utilization of "good practice" according to a bronchiolitis clinical practice guideline (CPG) in a population of infants hospitalized for acute bronchiolitis. METHOD: A decision-analysis model was developed in order to estimate the cost-effectiveness of the utilization of "good practice" compared with the lack of use of "good practice" according to a bronchiolitis evidence-based CPG. The effectiveness parameters and costs of the model were obtained from electronic medical records. The main outcome was the readmission of the patients within 10 days of post discharge. RESULTS: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of patients with bronchiolitis was associated with both fewer patients readmitted within 10 days of post discharge (0.88 vs 0.99 on average per patient) and lower costs (US$1529.3 versus $1709.1 average cost per patient), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses. CONCLUSIONS: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of acute bronchiolitis according to a bronchiolitis CPG is a dominant strategy because it involves both fewer patients readmitted within 10 days of post discharge and lower costs.
RATIONALE, AIMS, AND OBJECTIVES: The aim of the present study was to determine the cost-effectiveness of the utilization of "good practice" according to a bronchiolitis clinical practice guideline (CPG) in a population of infants hospitalized for acute bronchiolitis. METHOD: A decision-analysis model was developed in order to estimate the cost-effectiveness of the utilization of "good practice" compared with the lack of use of "good practice" according to a bronchiolitis evidence-based CPG. The effectiveness parameters and costs of the model were obtained from electronic medical records. The main outcome was the readmission of the patients within 10 days of post discharge. RESULTS: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of patients with bronchiolitis was associated with both fewer patients readmitted within 10 days of post discharge (0.88 vs 0.99 on average per patient) and lower costs (US$1529.3 versus $1709.1 average cost per patient), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses. CONCLUSIONS: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of acute bronchiolitis according to a bronchiolitis CPG is a dominant strategy because it involves both fewer patients readmitted within 10 days of post discharge and lower costs.
Authors: Juana Patricia Sánchez Villamil; Fernando P Polack; Jefferson Antonio Buendía Journal: BMC Public Health Date: 2020-11-10 Impact factor: 3.295
Authors: Simon van der Pol; Paula Rojas Garcia; Maarten J Postma; Fernando Antoñanzas Villar; Antoinette D I van Asselt Journal: Pharmacoeconomics Date: 2021-07-15 Impact factor: 4.981