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Gc, Vijay S., Franklin, Donna, Whitty, Jennifer A. 
ORCID: https://orcid.org/0000-0002-5886-1933, Dalziel, Stuart R., Babl, Franz E., Schlapbach, Luregn J., Fraser, John F., Craig, Simon, Neutze, Jocelyn, Oakley, Ed and Schibler, Andreas
(2020)
First line oxygen therapy with high-flow in bronchiolitis is not cost saving for the health service.
Archives of Disease in Childhood, 105 (10).
pp. 975-980.
ISSN 0003-9888
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Abstract
Background Bronchiolitis is the most common reason for hospital admission in infants. High-flow oxygen therapy has emerged as a new treatment; however, the cost-effectiveness of using it as first-line therapy is unknown. Objective To compare the cost of providing high-flow therapy as a first-line therapy compared with rescue therapy after failure of standard oxygen in the management of bronchiolitis. Methods A within-trial economic evaluation from the health service perspective using data from a multicentre randomised controlled trial for hypoxic infants (≤12 months) admitted to hospital with bronchiolitis in Australia and New Zealand. Intervention costs, length of hospital and intensive care stay and associated costs were compared for infants who received first-line treatment with high-flow therapy (early high-flow, n=739) or for infants who received standard oxygen and optional rescue high-flow (rescue high-flow, n=733). Costs were applied using Australian costing sources and are reported in 2016–2017 AU$. Results The incremental cost to avoid one treatment failure was AU$1778 (95% credible interval (CrI) 207 to 7096). Mean cost of bronchiolitis treatment including intervention costs and costs associated with length of stay was AU$420 (95% CrI −176 to 1002) higher per infant in the early high-flow group compared with the rescue high-flow group. There was an 8% (95% CrI 7.5 to 8.6) likelihood of the early high-flow oxygen therapy being cost saving. Conclusions The use of high-flow oxygen as initial therapy for respiratory failure in infants with bronchiolitis is unlikely to be cost saving to the health system, compared with standard oxygen therapy with rescue high-flow.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | costing,health economics,intensive care,respiratory,pediatrics, perinatology, and child health ,/dk/atira/pure/subjectarea/asjc/2700/2735 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 03 Apr 2020 00:45 |
| Last Modified: | 21 Apr 2023 00:23 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/74695 |
| DOI: | 10.1136/archdischild-2019-318427 |
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