Cost of home and hospital care for patients with cystic fibrosis followed up in two reference medical centers in France.
OBJECTIVE
In France, new guidelines for clinical practices concerning cystic fibrosis came out in 2002, underscoring the need for early and intensive management of this disease. Because no recent health economic studies on cystic fibrosis in France were available, we conducted a cost-analysis study before the new guidelines were put into practice, with a view to a later study on the medical and economic impact of these guidelines.


METHODS
A cost-analysis study was performed of the inpatient and outpatient costs of patients with cystic fibrosis for the 2000-2001 period. The various direct costs were estimated on a sample of sixty-five adult and pediatric patients managed for cystic fibrosis in two reference medical centers. Data were obtained from medical records, and questionnaires were filled out by the patients. Analysis was made from the perspective of the French healthcare system.


RESULTS
We studied sixty-five patients, 54 percent male patients and 72 percent children under 18 years of age. The total cost of cystic fibrosis care totaled 16,189 euros per year and per patient. Outpatient costs accounted for 88 percent of the total cost versus 12 percent for inpatient costs; medication costs were the highest with 21 percent of the total cost for home intravenous antibiotic treatments and 49 percent of the total cost for chronic medications.


CONCLUSIONS
The results show that outpatient costs were higher than inpatient costs, which could be related to the importance granted to home health care in France, notably for intravenous antibiotic treatments given for pulmonary complications.
Horvais
Valérie
V
Department of Medical Information, University Claude Bernard Lyon 1 and Hospices Civils de Lyon, France. valerie.horvais@chu-nantes.fr
Touzet
Sandrine
S
François
Sabrina
S
Bourdy
Stéphanie
S
Bellon
Gabriel
G
Colin
Cyrille
C
Durieu
Isabelle
I
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003550:Cystic Fibrosis / Q000191:economics* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D019983:Guideline Adherence / Q000191:economics*; D006699:Home Care Services / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents