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Cost-effectiveness analysis of child development evaluation test (CDE test or Prueba EDI) in children under 5 years
José R García-Lira1, Rita E Zapata-Vázquez2, Alfonso Reyes-López3
1Developmental-Behavioral Pediatrics Service, Hospital Infantil de México Federico Gómez, Mexico City.
Insights
The Child Development Evaluation (CDE) test is a cost-saving national screening tool for children under 5 in Mexico. It offers improved health outcomes and monetary benefits compared to standard medical consultations.
Area of Science:
- Health Economics
- Pediatric Screening
- Public Health Policy
Background:
- The Child Development Evaluation (CDE) test is now Mexico's national screening tool for children under five.
- This study evaluates the cost-effectiveness of the CDE test against standard medical consultations.
Purpose of the Study:
- To analyze the cost-effectiveness of the CDE test compared to standard medical consultation in Mexico.
- To assess the economic impact from the perspective of public and social sectors.
Main Methods:
- A cost-effectiveness analysis using a decision tree model was performed.
- Data up to 2020 was utilized, with costs in Mexican pesos (MXN) at 2019 prices.
- Monte Carlo simulation and probabilistic sensitivity analysis addressed variability and uncertainty.
Main Results:
- The CDE test demonstrated superior outcomes at reduced costs in most scenarios.
- Implementing CDE screening yielded an incremental net monetary benefit of $44,608 MXN (2019 value).
- Results consistently favored the CDE test over the standard approach.
Conclusions:
- The CDE test is cost-saving for Mexico's public and social sectors.
- It offers a net increase in monetary benefits and health outcomes.
- Feasible implementation can enhance long-term healthcare system efficiency.
Background:
The Health Ministry has incorporated the Child Development Evaluation test (CDE test) as the national screening tool for children < 5 years old. The aim of this study is to analyze the cost-effectiveness of the CDE test compared to standard medical consultation in Mexico.
Methods:
The study was conducted with information available until 2020. A cost-effectiveness analysis was conducted from perspective of the public/social sectors in Mexico with a decision tree model to evaluate the strategies. The time horizon was set at 1 year, no discounting applied. Costs were calculated in Mexican pesos (MXN) at 2019 prices and included both direct/indirect costs. Direct costs encompassed CDE test administration, specialist consultations, and rehabilitation sessions. Indirect costs considered transportation expenses and lost wages related to caregiving. To account for variability and uncertainty, a Monte Carlo simulation with 10,000 iterations was performed. Probabilistic sensitivity analysis was conducted to test robustness of the results.
Results:
The results confirm that the CDE test consistently outperforms the standard approach, delivering improved outcomes at reduced costs in the majority of scenarios. The incremental net monetary benefit of implementing CDE screening was $44,608 MXN (2019 value), providing additional evidence of its cost-effectiveness.
Conclusion:
This study suggests that the CDE test is cost-saving from the public and social sector perspective, generating a net increase in both monetary benefits and health outcomes. Furthermore, its implementation is feasible within the Mexican healthcare system, particularly considering its potential to enhance long-term efficiency.
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