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Cost effectiveness of ward based non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease: economic analysis of randomised controlled trial

Plant, P.K., Owen, J.L., Parrott, S. and Elliott, M.W. (2003) Cost effectiveness of ward based non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease: economic analysis of randomised controlled trial. British medical journal. pp. 956-960. ISSN 0959-535X

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Abstract

OBJECTIVE: To evaluate the cost effectiveness of standard treatment with and without the addition of ward based non-invasive ventilation in patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease. DESIGN: Incremental cost effectiveness analysis of a randomised controlled trial. SETTING: Medical wards in 14 hospitals in the United Kingdom. PARTICIPANTS: The trial comprised 236 patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease and mild to moderate acidosis (pH 7.25-7.35) secondary to respiratory failure. The economic analysis compared the costs of treatment that these patients received after randomisation. MAIN OUTCOME MEASURE: Incremental cost per in-hospital death. RESULTS: 24/118 died in the group receiving standard treatment and 12/118 in the group receiving non-invasive ventilation (P=0.05). Allocation to the group receiving non-invasive ventilation was associated with a reduction in costs of £49 362 ($78 741; 73 109), mainly through reduced use of intensive care units. The incremental cost effectiveness ratio was £645 per death avoided (95% confidence interval £2310 to £386), indicating a dominant (more effective and less costly) strategy. Modelling of these data indicates that a typical UK hospital providing a non-invasive ventilation service will avoid six deaths and three to nine admissions to intensive care units per year, with an associated cost reduction of £12 000-53 000 per year. CONCLUSIONS: Non-invasive ventilation is a highly cost effective treatment that both reduced total costs and improved mortality in hospital.

Item Type: Article
Copyright, Publisher and Additional Information: © 2003 BMJ Publishing Group Ltd
Keywords: POSITIVE PRESSURE VENTILATION, ACUTE RESPIRATORY-FAILURE, NONINVASIVE VENTILATION
Academic Units: The University of York > Health Sciences (York)
Depositing User: Repository Officer
Date Deposited: 24 Sep 2004
Last Modified: 17 Oct 2013 14:30
Published Version: http://dx.doi.org/10.1136/bmj.326.7396.956
Status: Published
Refereed: Yes
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/129

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