Author:
Pettersson Miriam,Ryen Linda,Eriksson Mats,Ohlin Andreas
Abstract
AbstractThis study aimed to establish the cost-effectiveness of home phototherapy versus hospital phototherapy treating hyperbilirubinemia in neonates more than 36 weeks. Based on clinical results from a randomised controlled trial showing that home phototherapy for hyperbilirubinemia in term neonates is as effective as hospital phototherapy, we performed a cost-minimisation analysis to identify the most cost-effective alternative. We included costs for health care resource use as well as costs for transportation in connection with re-visits. The cost per patient was €337 for home phototherapy compared with €1156 for the hospital alternative indicating average cost savings of €819 (95% confidence interval €613–1025) or 71% per patient. Transportation and outpatient costs were higher in the home treatment group and hospital care costs were higher in the hospital group. Sensitivity analysis shows that results are robust also when allowing for uncertainty. Home phototherapy for neonates more than 36 weeks costs less than in-hospital phototherapy while being equally effective, meaning that home phototherapy is a cost-effective alternative to hospital treatment for infants with neonatal hyperbilirubinemia.Trial registrationNCT03536078. Date of registration: 24/05/2018.
Funder
Uppsala and Örebro Regional County Council
Örebro University
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. Alkén, J., Ahlsson, F., Andersson, O., Odelberg-Johnson, P., Bohlin Blennow, K., & Norman, M. Vårdprogram, Neonatal Hyperbilirubinemi Svenska Neonatalföreningen. https://neo.barnlakarforeningen.se/wp-content/uploads/sites/14/2019/10/Vårdprogram-hyperbilirubinemi-2019.pdf (2019).
2. Kemper, A. R. et al. Clinical practice guideline revision: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 150(3), e2022058859 (2022).
3. Slater, L. & Brewer, M. F. Home versus hospital phototherapy for term infants with hyperbilirubinemia: A comparative study. Pediatrics 73(4), 515–519 (1984).
4. Eggert, L. D., Pollary, R. A., Folland, D. S. & Jung, A. L. Home phototherapy treatment of neonatal jaundice. Pediatrics 76, 579–584 (1985).
5. Mills, J. F. & Tudehope, D. Fibreoptic phototherapy for neonatal jaundice. Cochrane Database Syst. Rev. 1, CD002060. https://doi.org/10.1002/14651858.CD002060 (2001).