Document Detail


Clinical and economic choices in the treatment of respiratory infections in cystic fibrosis: comparing hospital and home care.
MedLine Citation:
PMID:  16242385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A cost-effectiveness evaluation comparing home-based and hospital-based treatment with intravenous antibiotics for respiratory exacerbations in adults with cystic fibrosis (CF) has not been previously undertaken. METHODS: The study was conducted in a UK adult CF centre from a health service perspective. Clinical outcome and resource use data were obtained from a retrospective one-year study and combined with unit cost data in an incremental economic analysis. The primary outcome measure was percentage change in FEV(1); "effectiveness" was defined as maintenance of baseline average FEV(1) over the one-year study period. RESULTS: 116 patients received 454 courses of intravenous antibiotics. At the end of 1 year, there had been a mean percentage decline in FEV(1) compared with baseline average for home-treated patients but an improvement for hospital-treated patients (Tukey's HSD mean difference 10.1%, 95% CI 2.9 to 17.2, p = 0.003). Treatment was deemed "effective" in more hospital (58.8%) than home (42.6%) patients. The cost of hospital treatment was higher than home treatment (mean difference 9,005 pounds, 95% CI 3,507 to 14,700, p<0.001). The mean ICER was 46,098 pounds (2.5th and 97.5th percentiles -374,044 and 362,472). CONCLUSIONS: Hospital treatment was more effective but more expensive than home treatment. Potential methods to improve outcome at home should be considered but these may have resource implications.
Authors:
J Thornton; R A Elliott; M P Tully; M Dodd; A K Webb
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-19
Journal Detail:
Title:  Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society     Volume:  4     ISSN:  1569-1993     ISO Abbreviation:  J. Cyst. Fibros.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-04-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101128966     Medline TA:  J Cyst Fibros     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  239-47     Citation Subset:  IM    
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, University of Manchester M13 9PL, UK. judith.thornton@manchester.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Anti-Bacterial Agents / administration & dosage,  economics*,  therapeutic use*
Chi-Square Distribution
Cost-Benefit Analysis
Cystic Fibrosis / microbiology*
Female
Forced Expiratory Volume / drug effects
Great Britain
Home Care Services / economics*
Hospitals, Special / economics*
Humans
Infusions, Intravenous
Lung Diseases / drug therapy*,  microbiology
Male
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
J Cyst Fibros. 2005 Dec;4(4):211-2   [PMID:  16230054 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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