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World Journal of Pediatrics
Published in: World Journal of Pediatrics 1/2018

01-02-2018 | Meta-Analysis

The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis: a decision analysis

Authors: Paula Heikkilä, Minna Mecklin, Matti Korppi

Published in: World Journal of Pediatrics | Issue 1/2018

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Abstract

Background

This study evaluated the cost-effectiveness of hypertonic saline (HS) inhalations for infant bronchiolitis, compared to normal saline inhalations or standard treatment without inhalations as controls.

Methods

The decision tree in the decision analysis was used to calculate the expected costs. Actual cost data were obtained from our retrospective case-control study on bronchiolitis treatment. The effectiveness of treatment, based on the hospitalization rate of those admitted to the emergency department and the length of stay (LOS) of those who were hospitalized, was collected from previous studies. For the effectiveness estimations, we made a meta-analysis summarizing the results of the meta-analysis of the Cochrane review in 2013 and the results of 10 studies published after it.

Results

The mean hospitalization rate was 24.7% in the HS inhalation group and 32.6% in the control group [risk ratio: 0.80, 95% confidence interval (CI) 0.67–0.96] and the mean LOS was 3.736 (HS group) and 4.292 (controls) days (mean difference: − 0.55 days, 95% CI − 0.96 to − 0.15), respectively. The expected costs per patient, when both inpatients and outpatients were included, were €816 ($1111) in the HS inhalation group and €962 ($1310) in the control group. The expected costs per hospitalization, when only inpatients were included, were €2600 ($3540) in the HS inhalation group and €2890 ($3935) in the control group.

Conclusions

HS inhalations slightly reduced the expected hospitalization costs of infant bronchiolitis. However, the low effectiveness, rather than the cost, is the factor that will limit the use of HS inhalations in infant bronchiolitis.
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Metadata
Title
The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis: a decision analysis
Authors
Paula Heikkilä
Minna Mecklin
Matti Korppi
Publication date
01-02-2018
Publisher
Childrens Hospital, Zhejiang University School of Medicine
Published in
World Journal of Pediatrics / Issue 1/2018
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-017-0112-8

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