Economic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis

Emerg Med Australas. 2017 Jun;29(3):324-329. doi: 10.1111/1742-6723.12713. Epub 2016 Dec 22.

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.

Keywords: bronchiolitis; child; economic evaluation; hydration; intravenous; nasogastric.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Australia
  • Bronchiolitis / economics
  • Bronchiolitis / therapy*
  • Cost-Benefit Analysis
  • Female
  • Fluid Therapy / economics
  • Fluid Therapy / methods*
  • Humans
  • Infant
  • Infusions, Intravenous / economics
  • Infusions, Intravenous / methods
  • Infusions, Intravenous / standards*
  • Intubation, Gastrointestinal / economics
  • Intubation, Gastrointestinal / methods
  • Intubation, Gastrointestinal / standards*
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Male
  • New Zealand