title: High-flow oxygen therapy is more cost-effective for bronchiolitis than standard treatment-A decision-tree analysis.
abstract: We evaluated the cost-effectiveness of high-flow nasal cannula (HFNC) to provide additional oxygen for infants with bronchiolitis, compared to standard low-flow therapy. The cost-effectiveness was evaluated by decision analyses, using decision tree modeling, and was based on real costs from our recently published retrospective case-control study. The data on the effectiveness of HFNC treatment were collected from earlier published retrospective studies, using admission rates to pediatric intensive care units (PICU). The analyses in the study showed that the expected treatment costs of each episode of infant bronchiolitis varied between €1,312-2,644 ($1,786-3,600) in the HFNC group and €1,598-3,764 ($2,175-5,125) in the standard treatment group. The PICU admission rates and consequential costs were lower for HFNC than for standard treatment. HFNC treatment proved more cost-effective than standard treatment in all the baseline analyses and was also more cost-effective in the sensitivity analyses, except for in the worst-case scenario analysis. In conclusion, our modeling demonstrated that HFNC was strongly cost-effective for infant bronchiolitis, compared to standard treatment because it was both more effective and less expensive. Thus, if children hospitalized for bronchiolitis need oxygen, it should be delivered as HFNC treatment. Pediatr Pulmonol. 2016;51:1393-1402. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Heikkilä
authors.affiliation: School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Forma
authors.affiliation: Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Korppi
mesh_terms: D000281:Administration, Intranasal; D001988:Bronchiolitis / Q000628:therapy*; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D010102:Oxygen Inhalation Therapy / Q000191:economics / Q000379:methods*; D012189:Retrospective Studies
keywords: bronchiolitis; cost-effectiveness; decision analysis; high-flow nasal cannula; hospitalization costs