title: Comparing costs of home- versus hospital-based treatment of infections in adults in a specialist cystic fibrosis center.
abstract: OBJECTIVE
  This study aimed to produce valid patient-based UK National Health Service (NHS) costs for adults with cystic fibrosis to identify differences between hospital- and home-based treatments for infections.
  
  
  METHODS
  A costing study was carried out in adults with cystic fibrosis (CF) in the United Kingdom, who required intravenous antibiotic treatments for respiratory infections, administered either at home or in the hospital. The perspective was that of the NHS hospital trust. Data were collected retrospectively for each patient for 1 year using clinical records. Data were collected for 116 adults with CF between 2000 and 2001, when 42,382 treatment days (454 courses) of intravenous antibiotics were administered; 213 courses with intention-to-treat at home and 241 courses with intention-to-treat in the hospital. The mean length of a course was 15.3 days.
  
  
  RESULTS
  Patients who had >60 percent of courses at home over 1 year had a mean cost of 13,528 UK pounds, compared with 22,609 pounds for patients who had > 60 percent of courses in the hospital, and a mean cost of 19,927 UK pounds for patients who had an equal mix of home and hospital care (p = .0001).
  
  
  CONCLUSIONS
  The key cost-generating events in CF respiratory infections are hospital admissions. Future studies assessing costs should concentrate on factors affecting admissions, length of stay, staff input, and alternative methods of home-care provision, rather than marginal effects, such as using different antibiotics.
authors.affiliation: ARC Epidemiology Unit, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK. Rachel.Elliott@havardpilgrim.org
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Elliott
authors.forename: Judith
authors.initials: J
authors.lastname: Thornton
authors.forename: A Kevin
authors.initials: AK
authors.lastname: Webb
authors.forename: Mary
authors.initials: M
authors.lastname: Dodd
authors.forename: Mary P
authors.initials: MP
authors.lastname: Tully
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003550:Cystic Fibrosis; D005260:Female; D006699:Home Care Services / Q000191:economics*; D006782:Hospitals, Special / Q000191:economics*; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013222:State Medicine / Q000191:economics*; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents