Management of childhood urinary tract infections: an economic modeling study

Area of Science:

• Pediatric Nephrology
• Health Economics
• Clinical Practice Guidelines

Background:

• Childhood urinary tract infections (UTIs) pose significant risks, including renal scarring and potential end-stage renal failure, impacting quality of life and healthcare costs.
• Current management of pediatric UTIs exhibits considerable variation across healthcare practices.

Purpose of the Study:

• To evaluate the cost-effectiveness of a "maximum care" model for pediatric UTIs in the Netherlands.
• This model involves increased diagnostic testing and antibiotic treatment compared to standard primary care.

Main Methods:

• A probabilistic modeling study utilizing Markov models was conducted.
• Data for the model were sourced from a systematic review of existing research literature.
• Probabilistic analyses were performed using multidimensional Monte Carlo simulation.

Main Results:

• The maximum care model demonstrated dominance over current care, yielding higher quality-adjusted life-years (QALYs) and lower costs over 30 years.
• Specifically, it gained 0.00102 QALYs for boys and 0.00219 QALYs for girls, while saving €42.70 and €77.81, respectively.
• The net monetary benefit ranged from €20 to €200, depending on the willingness-to-pay threshold for a QALY.

Conclusions:

• The study suggests that a maximum care approach for childhood UTIs is a dominant, cost-effective strategy in the long run.
• However, limitations in the input data necessitate caution when drawing definitive conclusions.