Cost-effectiveness of the utilization of "good practice" or the lack thereof according to a bronchiolitis evidence-based clinical practice guideline.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE

Original Publication: Oxford, England : Wiley-Blackwell, c1995-

Evidence-Based Practice*/economics ; Evidence-Based Practice*/methods ; Evidence-Based Practice*/standards ; Patient Care*/economics ; Patient Care*/methods ; Patient Care*/standards; Bronchiolitis/*therapy; Colombia ; Cost-Benefit Analysis ; Decision Support Techniques ; Electronic Health Records/statistics & numerical data ; Humans ; Infant ; Patient Readmission/statistics & numerical data ; Practice Guidelines as Topic

Rationale, Aims, and Objectives: The aim of the present study was to determine the cost-effectiveness of the utilization of "good practice" according to a bronchiolitis clinical practice guideline (CPG) in a population of infants hospitalized for acute bronchiolitis.
Method: A decision-analysis model was developed in order to estimate the cost-effectiveness of the utilization of "good practice" compared with the lack of use of "good practice" according to a bronchiolitis evidence-based CPG. The effectiveness parameters and costs of the model were obtained from electronic medical records. The main outcome was the readmission of the patients within 10 days of post discharge.
Results: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of patients with bronchiolitis was associated with both fewer patients readmitted within 10 days of post discharge (0.88 vs 0.99 on average per patient) and lower costs (US$1529.3 versus $1709.1 average cost per patient), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusions: Compared with lack of "good practice," the utilization of "good practice" in the diagnosis and management of acute bronchiolitis according to a bronchiolitis CPG is a dominant strategy because it involves both fewer patients readmitted within 10 days of post discharge and lower costs.
(© 2019 John Wiley & Sons, Ltd.)

Keywords: bronchiolitis; clinical practice guidelines; cost-effectiveness; health economics

Date Created: 20190517 Date Completed: 20200521 Latest Revision: 20220409

20240829

10.1111/jep.13157

31095842