SETTING: Cape Town, South Africa, 2014. OBJECTIVES: To assess the societal costs and cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis. DESIGN: This was an economic evaluation from a societal perspective using probabilistic analysis. Health care, informal care, lost productivity costs and costs in other sectors, health-related quality of life (HRQoL) and family impact were assessed during interviews with care givers, children, medical staff and management. RESULTS: Societal costs for home-based treatment were USD3857, and USD28 043 for in-hospital treatment. Home-based vs. in-hospital treatment HRQoL scores were 90.9% vs. 84.5%, while family impact scores were 94.8% vs. 73.1%. The point estimate of the incremental cost-effectiveness ratio indicated that improving HRQoL and family impact by 1% was associated with a saving of respectively USD3726 and USD1140 for home-based vs. in-hospital treatment. The probability that home-based treatment was less expensive and more effective than in-hospital treatment was 96.3% for HRQoL and 100% for family impact. CONCLUSIONS: Societal costs of home-based treatment were lower than for in-hospital treatment. Children treated at home had a better HRQoL and family impact scores. Home-based treatment was a cost-effective alternative to in-hospital treatment of drug-susceptible tuberculous meningitis.

Additional Metadata
Keywords Cost-effectiveness, Home-based treatment, Paediatric, TBM
Persistent URL dx.doi.org/10.5588/ijtld.18.0236, hdl.handle.net/1765/110552
Journal International Journal of Tuberculosis and Lung Disease
Rights no subscription
Citation
van Elsland, S.L, Van Dongen, S.I. (S. I.), Bosmans, J.E, Schaaf, H.S. (H. S.), van Toorn, R, & van Furth, A.M. (2018). Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis. International Journal of Tuberculosis and Lung Disease, 22(10), 1188–1195. doi:10.5588/ijtld.18.0236