Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic
Data(s) |
01/01/2006
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Resumo |
<b>Background: </b>Overwhelming, sometimes fatal infections represent a lifelong risk after surgical removal of the spleen, or in patients who develop hyposplenism as a consequence of illnesses. This risk may be reduced by all or a combination of vaccination, antibiotic prophylaxis and education. We aimed to determine if a registry approach to delivering these interventions would be cost effective using our own experience and published data.<br /><b>Method:</b> The decision model compared a cohort of 1,000 people covered by a registry to a cohort of 1,000 people with no registry. The impact of the registry was assessed in terms of achieved rates of vaccination, chemoprophylaxis and education, consequent outcomes of overwhelming post-splenectomy infection (OPSI) and mortality (years of life lived). The cost-effectiveness of the registry compared with no registry was estimated in terms of additional cost per case of OPSI avoided and as additional cost per life year gained.<br /><b>Results: </b>In the first two years, the additional cost of the registry was $152,611 per case of OPSI avoided or $205,931 per life year gained. After this initial registration period the costeffectiveness improves over time, such that over the cohort lifetime a post-splenectomy register is associated with an additional cost of $105,159 per case of OPSI avoided or $16,113 per life year gained.<br /><b>Conclusion:</b> A registry-based approach is likely to prove cost effective in terms of mortality and rates of OPSI avoided.<br /> |
Identificador | |
Idioma(s) |
eng |
Publicador |
Public Health Association of Australia |
Relação |
http://dro.deakin.edu.au/eserv/DU:30009299/gold-costeffectiveness-2006.pdf http://dx.doi.org/10.1111/j.1467-842X.2006.tb00786.x |
Direitos |
2006, Public Health Association of Australia |
Palavras-Chave | #amoxicillin #antibiotic agent #haemophilus influenzae type b vaccine #influenza vaccine #meningococcus vaccine #penicillin V #pneumococcus vaccine #antibiotic prophylaxis #postoperative complications #sepsis #splenectomy |
Tipo |
Journal Article |