gold-costeffectiveness-2006.pdf (289.48 kB)
Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic
journal contribution
posted on 2006-01-01, 00:00 authored by I Woolley, P Jones, D Spelman, Lisa GoldLisa GoldBackground: 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.
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.
History
Journal
Australian and New Zealand journal of public healthVolume
30Issue
6Pagination
558 - 561Publisher
Public Health Association of AustraliaLocation
Melbourne, Vic.Publisher DOI
ISSN
1326-0200eISSN
1753-6405Language
engNotes
Reproduced with the kind permission of the copyright owner.Publication classification
C1.1 Refereed article in a scholarly journal; C Journal articleCopyright notice
2006, Public Health Association of AustraliaUsage metrics
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amoxicillinantibiotic agenthaemophilus influenzae type b vaccineinfluenza vaccinemeningococcus vaccinepenicillin Vpneumococcus vaccineantibiotic prophylaxispostoperative complicationssepsissplenectomyScience & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational HealthSICKLE-CELL-ANEMIAOVERWHELMING SEPSISINFECTIONIMMUNIZATIONPROPHYLAXISMANAGEMENTCHILDREN
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