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Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic

Woolley, Ian, Jones, Penelope, Spelman, Denis and Gold, Lisa 2006, Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic, Australian and New Zealand journal of public health, vol. 30, no. 6, pp. 558-561.

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Title Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic
Author(s) Woolley, Ian
Jones, Penelope
Spelman, Denis
Gold, Lisa
Journal name Australian and New Zealand journal of public health
Volume number 30
Issue number 6
Start page 558
End page 561
Publisher Public Health Association of Australia
Place of publication Melbourne, Vic.
Publication date 2006
ISSN 1440-1614
Keyword(s) amoxicillin
antibiotic agent
haemophilus influenzae type b vaccine
influenza vaccine
meningococcus vaccine
penicillin V
pneumococcus vaccine
antibiotic prophylaxis
postoperative complications
sepsis
splenectomy
Summary Background: 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.
Method: 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.
Results: 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.
Conclusion: A registry-based approach is likely to prove cost effective in terms of mortality and rates of OPSI avoided.
Notes Reproduced with the kind permission of the copyright owner.
Language eng
Field of Research 140208 Health Economics
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2006, Public Health Association of Australia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009299

Document type: Journal Article
Collections: School of Health and Social Development
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