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Cost-effectiveness of implementing national guidelines in the treatment of acute otitis media in children

Published online by Cambridge University Press:  19 September 2006

Hanna Koskinen ,
Ulla-Maija Rautakorpi ,
Harri Sintonen ,
Pekka Honkanen ,
Solja Huikko ,
Pentti Huovinen ,
Timo Klaukka ,
Erkki Palva ,
Risto P. Roine  and
Hannu Sarkkinen
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Hanna Koskinen
Affiliation:
Social Insurance Institution and National Research and Development Centre for Welfare and Health
Ulla-Maija Rautakorpi
Affiliation:
National Research and Development Centre for Welfare and Health
Harri Sintonen
Affiliation:
University of Helsinki and National Research and Development Centre for Welfare and Health
Pekka Honkanen
Affiliation:
Kemi Health Centre
Solja Huikko
Affiliation:
University of Tampere and National Public Health Institute
Pentti Huovinen
Affiliation:
National Public Health Institute
Timo Klaukka
Affiliation:
Social Insurance Institution
Erkki Palva
Affiliation:
National Agency for Medicines
Risto P. Roine
Affiliation:
Helsinki and Uusimaa Hospital District
Hannu Sarkkinen
Affiliation:
Päijät-Häme Central Hospital
Helena Varonen
Affiliation:
Finnish Institute of Occupational Health and Finnish Medical Society Duodecim
Marjukka Mäkelä
Affiliation:
National Research and Development Centre for Welfare and Health
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Abstract

Objectives: Acute otitis media (AOM) is one of the most common diseases of childhood, representing a major disease burden on the society. New evidence-based guidelines for AOM, focusing on children under 7 years of age, were introduced in Finland in 1999. The aim of this study was to evaluate the cost-effectiveness of implementing those guidelines in Finland.

Methods: A 5-year prospective trial was conducted in thirty community primary healthcare centers in Finland. All AOM patients between 0 and 6 years of age visiting the study health centers for the first time, for this episode of illness, during 1 week in November 1998 (n = 579) and November 2002 (n = 369) were included in this study. The outcome measure was the percentage of symptom-free patients.

Results: The mean direct cost of an AOM episode per patient stayed almost the same after implementing the guidelines, €152 in 1998 and €150 in 2002. After implementing the guidelines, the percentage of symptom-free patients was 10 percentage points higher than before the guidelines. The treatment after the implementation of the guidelines, thus, was a dominant strategy.

Conclusions: Implementing the guidelines to the treatment of AOM in children was associated with extra health benefits at slightly lower direct costs and, thus, is a dominant strategy. The focus of this study was on the short-term effects of the treatment; including long-term effects in the analysis might affect the results.

Keywords

Cost-effectivenessAcute otitis mediaPractice guidelinesImplementation
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 4 , October 2006 , pp. 454 - 459
Copyright
© 2006 Cambridge University Press

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