Hydrostatic reduction is Cost-effective in the management of pediatric intussusception in Nigeria: A decision analysis

Abstract

Background: The cost of hydrostatic reduction, the cost of operative treatment of intussusceptions as well as the assessment of the cost-effectiveness of hydrostatic reduction in treating pediatric intussusceptions have not been documented in our environment. Objectives: To estimate the cost of hydrostatic reduction of intussusceptions, the cost of operative treatment of intussusceptions and assess if hydrostatic reduction is cost-effective in management of intussusception. Methods: The medical records of children who were managed for intussusception were reviewed. Micro-costing was used to calculate expenditure on treatment modalities. Decision-analytic Markov model was used to determine the cost-effectiveness of hydrostatic reduction. Results: The average cost of hydrostatic reduction was $116 USD and that of operative treatment was $ 393.62 USD. At the success rate of 44% for hydrostatic reduction, initial attempts at hydrostatic reduction are still cost-effective at the overall cost of $336.6 USD. The expenditure on drugs ($ 68.4 USD) and investigations ($46.58 USD) contributed most to the total cost. Planning hydrostatic reduction to coincide with the initial abdominal ultrasonography will reduce the overall cost by $8.1USD Conclusions: Hydrostatic reduction once indicated should be attempted before operative treatment in any facilities where the success rate of hydrostatic reduction is above 30%. To further reduce cost, the first ultrasonography should be targeted to correspond with the hydrostatic reduction procedure.