Direct healthcare costs in the first 2 years of life: A comparison of screened and clinically diagnosed children with cystic fibrosis - The Irish comparative outcomes study of CF (ICOS).

Autor: Somerville R; Department of Public Health, Health Service Executive East, Dublin, Ireland; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland., Fitzgerald C; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland., Segurado R; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland; Centre for Support and Training in Analysis and Research, University College Dublin, Dublin, Ireland., Kapur K; School of Economics, University College Dublin, Dublin, Ireland., George S; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland., Bhardwaj N; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland., Linnane B; Department of Paediatrics, University Hospital Limerick, Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland., O'Ceilleachair A; School of Public Health, University College Cork, Cork, Ireland., Staines A; School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland., Fitzpatrick P; School of Public Health, Physiotherapy and Sports Science, Unversity College Dublin, Belfield, Dublin 4, Ireland. Electronic address: patricia.fitzpatrick@ucd.ie.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2024 Sep; Vol. 23 (5), pp. 896-902. Date of Electronic Publication: 2024 Jul 03.
DOI: 10.1016/j.jcf.2024.06.015
Abstrakt: Background: In July 2011, Cystic Fibrosis (CF) was added to the Newborn Bloodspot Screening Programme in Ireland. The Irish Comparative Outcomes Study (ICOS) is a historical cohort study established to compare outcomes between clinically-detected and screen-detected children with CF. Here we present the results of economic analysis comparing direct healthcare costs in the first 2 years of life of children born between mid-2008 and mid-2016, in the pre-CF transmembrane conductance regulator modulator era.
Methods: Healthcare resource use information was obtained from Cystic Fibrosis Registry of Ireland (CFRI), medical records and parental questionnaire. Hospital admissions, emergency department visits, outpatient appointments, antibiotics and maintenance medications were included. Costs were estimated using the Health Service Executive Casemix, Irish Medicines Formulary and hospital pharmacy data, adjusted for inflation using Consumer Price Index data from the Central Statistics Office. A Negative Binomial regression was used, with time in the study as an offset.
Results: Overall participation was 93 %. After exclusion of those with meconium ileus, data from 139 patients, with follow-up to 2 years of age, were available. 72 (51.8 %) were from the clinically diagnosed cohort. In the final model (n=105), clinically diagnosed children had 2.62-fold higher costs per annum (p<0.0001), when adjusted for confounders, including homozygous ΔF508 or G511D mutation, socio-demographic factors and time between diagnosis and first CFRI interaction.
Conclusions: There are few studies evaluating economic aspects of newborn screening for CF using routine care data. These results imply that the benefits of newborn screening extend to direct healthcare costs borne by the State.
Competing Interests: Declaration of competing interest We have no conflict of interest to disclose.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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