Document Detail


Cost-effectiveness of community-based treatment of severe acute malnutrition in children.
MedLine Citation:
PMID:  20950075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe acute malnutrition affects 20 million children aged under 5 years old worldwide. Medical complications and death are common, but nutritional and medical treatment can result in good outcomes. Randomized trials of treatment after in-patient stabilization have shown community-based treatment to have similar outcomes to hospital-based treatment, at lower cost. Community-based ambulatory treatment, with in-patient care reserved for the most severe cases, is increasingly being implemented in Africa but has not been evaluated in randomized trials. Community-based treatment programs have shown favorable outcomes. Economic evaluations of community-based treatment have included cost analyses, cost and consequence analyses and decision analyses. Treatment costs have been consistently lower than for institution-based treatment. Costs of ambulatory community-based treatment of severe acute malnutrition have ranged between US$46 to $453 per child, depending on the type of care provided and the costing methods used. Recent studies have reported on costs and outcomes of similar large-scale African programs covering geographically defined populations, with ambulatory care for most children, and initial in-patient stabilization for the minority with most severe disease. In these studies the costs ranged from US$129 to $201 per child, and mortality rates ranged from 1.2 to 9.2%, depending on length of follow-up. A decision tree model based on such a program in Zambia estimated that community-based treatment of severe acute malnutrition in primary-care centers, with hospital access, cost US$203 per case treated, US$1760 per life saved, and US$53 per disability-adjusted life year gained, compared with no treatment. This latter cost per disability-adjusted life year gained suggests that community-based treatment of severe acute malnutrition is cost effective compared with other priority health interventions in low-income countries, and compared with such countries' national incomes.
Authors:
Max Oscar Bachmann
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Expert review of pharmacoeconomics & outcomes research     Volume:  10     ISSN:  1744-8379     ISO Abbreviation:  Expert Rev Pharmacoecon Outcomes Res     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-18     Completed Date:  2011-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101132257     Medline TA:  Expert Rev Pharmacoecon Outcomes Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  605-12     Citation Subset:  IM    
Affiliation:
Medical School, University of East Anglia, Norwich NR4 7TJ, UK. m.bachmann@uea.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Africa / epidemiology
Ambulatory Care / economics*,  methods
Child Nutrition Disorders / economics,  epidemiology,  therapy*
Child, Preschool
Community Health Services / economics*,  methods
Cost-Benefit Analysis
Decision Trees
Developing Countries
Humans
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic
Severity of Illness Index

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


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