Cost-effectiveness of community-based treatment of severe acute malnutrition in children

Bachmann, Max Oscar (2010) Cost-effectiveness of community-based treatment of severe acute malnutrition in children. Expert Review of Pharmacoeconomics & Outcomes Research, 10 (5). pp. 605-612. ISSN 1473-7167

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Abstract

Severe acute malnutrition affects 20 million children aged under 5 years old worldwide. Medical complications and death are common, but nutritional and medical treatment can result in good outcomes. Randomized trials of treatment after in-patient stabilization have shown community-based treatment to have similar outcomes to hospital-based treatment, at lower cost. Community-based ambulatory treatment, with in-patient care reserved for the most severe cases, is increasingly being implemented in Africa but has not been evaluated in randomized trials. Community-based treatment programs have shown favorable outcomes. Economic evaluations of community-based treatment have included cost analyses, cost and consequence analyses and decision analyses. Treatment costs have been consistently lower than for institution-based treatment. Costs of ambulatory community-based treatment of severe acute malnutrition have ranged between US$46 to $453 per child, depending on the type of care provided and the costing methods used. Recent studies have reported on costs and outcomes of similar large-scale African programs covering geographically defined populations, with ambulatory care for most children, and initial in-patient stabilization for the minority with most severe disease. In these studies the costs ranged from US$129 to $201 per child, and mortality rates ranged from 1.2 to 9.2%, depending on length of follow-up. A decision tree model based on such a program in Zambia estimated that community-based treatment of severe acute malnutrition in primary-care centers, with hospital access, cost US$203 per case treated, US$1760 per life saved, and US$53 per disability-adjusted life year gained, compared with no treatment. This latter cost per disability-adjusted life year gained suggests that community-based treatment of severe acute malnutrition is cost effective compared with other priority health interventions in low-income countries, and compared with such countries' national incomes.

Item Type: Article
Uncontrolled Keywords: acute disease,africa,ambulatory care,child nutrition disorders,child, preschool,community health services,cost-benefit analysis,decision trees,developing countries,humans,quality-adjusted life years,randomized controlled trials as topic,severity of illness index
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:
Depositing User: Rhiannon Harvey
Date Deposited: 01 Jun 2011 11:50
Last Modified: 21 Apr 2020 16:58
URI: https://ueaeprints.uea.ac.uk/id/eprint/31686
DOI: 10.1586/erp.10.54

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