Volume 29, Issue 3 pp. 324-329
Original Research

Economic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis

Ed Oakley

Corresponding Author

Ed Oakley

Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

Correspondence: Dr Ed Oakley, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia. Email: [email protected]Search for more papers by this author
Rob Carter

Rob Carter

Deakin Health Economics, Population Health SRC, Faculty of Health, Deakin University, Melbourne, Victoria, Australia

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Bridie Murphy

Bridie Murphy

Deakin Health Economics, Population Health SRC, Faculty of Health, Deakin University, Melbourne, Victoria, Australia

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Meredith Borland

Meredith Borland

Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia

School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia

School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Western Australia, Australia

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Jocelyn Neutze

Jocelyn Neutze

Department of Emergency Medicine, Kidz First Hospital, Auckland, New Zealand

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Jason Acworth

Jason Acworth

Department of Emergency Medicine, Lady Cilento Hospital, Brisbane, Queensland, Australia

Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia

Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia

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David Krieser

David Krieser

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia

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Stuart Dalziel

Stuart Dalziel

Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand

Liggins Institute, The University of Auckland, Auckland, New Zealand

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Andrew Davidson

Andrew Davidson

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia

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Susan Donath

Susan Donath

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

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Kim Jachno

Kim Jachno

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

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Mike South

Mike South

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

Department of Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia

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Franz E Babl,

Franz E Babl,

Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia

Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia

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for the Paediatric Research in Emergency Departments International Collaborative (PREDICT)

for the Paediatric Research in Emergency Departments International Collaborative (PREDICT)

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First published: 22 December 2016
Citations: 15
Ed Oakley, MBBS, Director Emergency Medicine; Rob Carter, PhD, Professor; Bridie Murphy, PhD, Lecturer; Meredith Borland, MBBS, Director Emergency Medicine; Jocelyn Neutze, MBChB, Paediatrician; Jason Acworth, MBBS, Director Emergency Medicine; David Krieser, MBBS, Paediatric Emergency Physician; Stuart Dalziel, PhD, Paediatric Emergency Physician; Andrew Davidson, MBBS, Staff Specialist; Susan Donath, PhD, Deputy Director; Kim Jachno, MSc, Statistician; Mike South, MD, Paediatrician; Franz E Babl, MD, Paediatric Emergency Physician.

Abstract

Objective

Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration (IVH) was more cost-effective than nasogastric hydration (NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2–12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis.

Methods

Cost data collections included hospital and intervention-specific costs. The economic analysis was reduced to a cost-minimisation study, focusing on intervention-specific costs of IVH versus NGH, as length of stay was equal between groups. All analyses are reported as intention to treat.

Results

Intervention costs were greater for IVH than NGH ($113 vs $74; cost difference of $39 per child). The intervention-specific cost advantage to NGH was robust to inter-site variation in unit prices and treatment activity.

Conclusion

Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites.

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