title: Economic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis.
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.
  
  
  CONCLUSIONS
  Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites.
authors.affiliation: Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Ed
authors.initials: E
authors.lastname: Oakley
authors.affiliation: Deakin Health Economics, Population Health SRC, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Rob
authors.initials: R
authors.lastname: Carter
authors.affiliation: Deakin Health Economics, Population Health SRC, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Bridie
authors.initials: B
authors.lastname: Murphy
authors.affiliation: Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.|School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.|School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Borland
authors.affiliation: Department of Emergency Medicine, Kidz First Hospital, Auckland, New Zealand.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Neutze
authors.affiliation: Department of Emergency Medicine, Lady Cilento Hospital, Brisbane, Queensland, Australia.|Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia.|Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Acworth
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Krieser
authors.affiliation: Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.|Liggins Institute, The University of Auckland, Auckland, New Zealand.
authors.forename: Stuart
authors.initials: S
authors.lastname: Dalziel
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davidson
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Donath
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Jachno
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: South
authors.affiliation: Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Franz E
authors.initials: FE
authors.lastname: Babl
mesh_terms: D001315:Australia; D001988:Bronchiolitis / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D005440:Fluid Therapy / Q000191:economics / Q000379:methods*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous / Q000191:economics / Q000379:methods / Q000592:standards*; D007441:Intubation, Gastrointestinal / Q000191:economics / Q000379:methods / Q000592:standards*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D009520:New Zealand
keywords: bronchiolitis; child; economic evaluation; hydration; intravenous; nasogastric