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Oxygen saturation thresholds for bronchiolitis at high altitudes: a cost-effectiveness analysis.

Carlos E Rodriguez-Martinez1,2, Monica P Sossa-Briceño3, Gustavo Nino4

  • 1Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.

Expert Review of Pharmacoeconomics & Outcomes Research
|March 15, 2023
PubMed
Summary

Using an 85% oxygen saturation threshold for infants with viral bronchiolitis at high altitudes is more cost-effective than 90%, reducing costs and hospitalizations. This approach is logical and secure for managing bronchiolitis in these populations.

Keywords:
Cost‐effectivenesshealth economicshigh-altitudeoxygen saturationoxygen therapyviral bronchiolitis

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Area of Science:

  • Pediatrics
  • Pulmonology
  • Health Economics

Background:

  • Over-reliance on pulse oximetry (SpO2) thresholds may lead to unnecessary hospitalizations for viral bronchiolitis.
  • High-altitude residents may be particularly affected by arbitrary SpO2 thresholds.

Purpose of the Study:

  • To compare the cost-effectiveness of two SpO2 thresholds for hospital admission decisions in infants with viral bronchiolitis at high altitudes.

Main Methods:

  • A cost-effectiveness analysis was conducted in Bogota, Colombia (2640 m).
  • Two SpO2 thresholds were compared: 90% and 85% (altitude-adjusted).
  • The primary outcome measured was the avoidance of hospital admission.

Main Results:

  • An SpO2 threshold of 85% resulted in lower average costs per patient (US$130.4 vs. US$194.0).
  • The 85% threshold demonstrated a higher probability of avoiding hospital admission (0.7500 vs. 0.5900).

Conclusions:

  • Using an SpO2 threshold below 90% is a logical and secure strategy.
  • An SpO2 threshold of 85% is cost-effective for managing infants with viral bronchiolitis at high altitudes.