Cost-effectiveness analysis of oral rehydration therapy compared to intravenous rehydration for acute gastroenteritis...

Area of Science:

• Pediatric Emergency Medicine
• Public Health Economics
• Gastroenterology

Background:

• Diarrhea affects 1.7 billion children under 5 annually, causing 760,000 deaths.
• Despite being preventable and treatable, diarrhea remains a major global health issue for young children.
• This study focuses on cost-effectiveness for managing acute gastroenteritis with non-severe dehydration in emergency settings.

Purpose of the Study:

• To assess the cost-effectiveness of different diarrhea treatment strategies for children with non-severe dehydration.
• To compare interventions within the Brazilian public health system's perspective.
• To identify the most efficient management approach for pediatric acute gastroenteritis.

Main Methods:

• A stochastic decision tree model was employed to evaluate five distinct treatment interventions.
• Interventions included various combinations of oral rehydration therapy (ORT) at home, supervised ORT, and intravenous rehydration therapy (IVT).
• Quality-adjusted life year (QALY) was utilized as the primary measure for clinical outcomes.

Main Results:

• Initiating oral rehydration therapy (ORT) in children under 5 was identified as the most efficient strategy.
• This approach yielded an effectiveness of 0.89 QALYs at a cost of $14.28.
• The results highlight ORT's superior value in managing non-severe dehydration.

Conclusions:

• Oral rehydration therapy (ORT) is an underutilized yet highly effective resource in emergency services for non-severe pediatric dehydration.
• Intravenous rehydration therapy (IVT) is frequently overprescribed, leading to increased costs without substantial gains in clinical effectiveness.
• Optimizing ORT use can improve resource allocation and patient outcomes in pediatric gastroenteritis management.