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Comparing costs of home- versus hospital-based treatment of infections in adults in a specialist cystic fibrosis center

Published online by Cambridge University Press:  25 October 2005

Rachel A. Elliott ,
Judith Thornton ,
A. Kevin Webb ,
Mary Dodd  and
Mary P. Tully
Rachel A. Elliott
Affiliation:
University of Manchester
Judith Thornton
Affiliation:
University of Manchester
A. Kevin Webb
Affiliation:
Wythenshawe Hospital
Mary Dodd
Affiliation:
Wythenshawe Hospital
Mary P. Tully
Affiliation:
University of Manchester
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Abstract

Objectives: 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, compared with £22,609 for patients who had >60 percent of courses in the hospital, and a mean cost of £19,927 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.

Keywords

Economic evaluationCystic fibrosisAntibiotic treatmentCosting methodology
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 4 , October 2005 , pp. 506 - 510
Copyright
© 2005 Cambridge University Press

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