Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis

S. L. Van Elsland, S. I. Van Dongen, J. E. Bosmans, H. S. Schaaf, R. Van Toorn, A. M. Van Furth

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

SETTING: Cape Town, South Africa, 2014. OBJECTIVES: 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. CONCLUSIONS: 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.

Original languageEnglish
Pages (from-to)1188-1195
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume22
Issue number10
DOIs
Publication statusPublished - 1 Oct 2018

Cite this

Van Elsland, S. L. ; Van Dongen, S. I. ; Bosmans, J. E. ; Schaaf, H. S. ; Van Toorn, R. ; Van Furth, A. M. / Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis. In: International Journal of Tuberculosis and Lung Disease. 2018 ; Vol. 22, No. 10. pp. 1188-1195.
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abstract = "SETTING: Cape Town, South Africa, 2014. OBJECTIVES: 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. CONCLUSIONS: 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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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.

In: International Journal of Tuberculosis and Lung Disease, Vol. 22, No. 10, 01.10.2018, p. 1188-1195.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis

AU - Van Elsland, S. L.

AU - Van Dongen, S. I.

AU - Bosmans, J. E.

AU - Schaaf, H. S.

AU - Van Toorn, R.

AU - Van Furth, A. M.

PY - 2018/10/1

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N2 - SETTING: Cape Town, South Africa, 2014. OBJECTIVES: 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. CONCLUSIONS: 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.

AB - SETTING: Cape Town, South Africa, 2014. OBJECTIVES: 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. CONCLUSIONS: 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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KW - Home-based treatment

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U2 - 10.5588/ijtld.18.0236

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SP - 1188

EP - 1195

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

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