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Cost‐effectiveness of the utilization of “good practice” or the lack thereof according to a bronchiolitis evidence‐based clinical practice guideline
Author(s) -
RodriguezMartinez Carlos E.,
SossaBriceño Monica P.,
CastroRodriguez Jose A.
Publication year - 2019
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13157
Subject(s) - bronchiolitis , medicine , guideline , clinical practice , intensive care medicine , population , emergency medicine , family medicine , environmental health , pathology , respiratory system
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.