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Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis.
van Elsland, S L; van Dongen, S I; Bosmans, J E; Schaaf, H S; van Toorn, R; van Furth, A M.
Afiliación
  • van Elsland SL; Department of Paediatric Infectious Diseases and Immunology, Vrije Universiteit University Medical Centre, Amsterdam, The Netherlands, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, and Tygerberg Hospital, Cape Town, South Africa.
  • van Dongen SI; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
  • Bosmans JE; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam.
  • Schaaf HS; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, and Tygerberg Hospital, Cape Town, South Africa.
  • van Toorn R; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, and Tygerberg Hospital, Cape Town, South Africa.
  • van Furth AM; Department of Paediatric Infectious Diseases and Immunology, Vrije Universiteit University Medical Centre, Amsterdam, The Netherlands.
Int J Tuberc Lung Dis ; 22(10): 1188-1195, 2018 10 01.
Article en En | MEDLINE | ID: mdl-30236187
SETTING: Cape Town, South Africa, 2014. OBJECTIVE: To assess the societal costs and cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis. DESIGN: This was an economic evaluation from a societal perspective using probabilistic analysis. Health care, informal care, lost productivity costs and costs in other sectors, health-related quality of life (HRQoL) and family impact were assessed during interviews with care givers, children, medical staff and management. RESULTS: Societal costs for home-based treatment were USD3857, and USD28 043 for in-hospital treatment. Home-based vs. in-hospital treatment HRQoL scores were 90.9% vs. 84.5%, while family impact scores were 94.8% vs. 73.1%. The point estimate of the incremental cost-effectiveness ratio indicated that improving HRQoL and family impact by 1% was associated with a saving of respectively USD3726 and USD1140 for home-based vs. in-hospital treatment. The probability that home-based treatment was less expensive and more effective than in-hospital treatment was 96.3% for HRQoL and 100% for family impact. CONCLUSION: Societal costs of home-based treatment were lower than for in-hospital treatment. Children treated at home had a better HRQoL and family impact scores. Home-based treatment was a cost-effective alternative to in-hospital treatment of drug-susceptible tuberculous meningitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Meníngea / Costos de la Atención en Salud / Servicios de Atención de Salud a Domicilio / Hospitalización Tipo de estudio: Health_economic_evaluation / Qualitative_research Aspecto: Patient_preference Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2018 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Francia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Meníngea / Costos de la Atención en Salud / Servicios de Atención de Salud a Domicilio / Hospitalización Tipo de estudio: Health_economic_evaluation / Qualitative_research Aspecto: Patient_preference Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2018 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Francia