Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy
Richard J Milne,1,2 Hans-Ulrich Hockey,3 Jeffrey Garrett4 1Health Outcomes Associates Ltd, Auckland, New Zealand; 2School of Pharmacy, University of Auckland, Auckland, New Zealand; 3Biometrics Matters Ltd, Hamilton, New Zealand; 4Middlemore Hospital, Auckland, New ZealandCorrespondence: Richard J M...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-06-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/hospital-cost-savings-for-sequential-copd-patients-receiving-domicilia-peer-reviewed-fulltext-article-COPD |
| _version_ | 1811345307782348800 |
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| author | Milne RJ Hockey HU Garrett J |
| author_facet | Milne RJ Hockey HU Garrett J |
| author_sort | Milne RJ |
| collection | DOAJ |
| description | Richard J Milne,1,2 Hans-Ulrich Hockey,3 Jeffrey Garrett4 1Health Outcomes Associates Ltd, Auckland, New Zealand; 2School of Pharmacy, University of Auckland, Auckland, New Zealand; 3Biometrics Matters Ltd, Hamilton, New Zealand; 4Middlemore Hospital, Auckland, New ZealandCorrespondence: Richard J Milne, Health Outcomes Associates Ltd, 260 Major Hornbrook Road, Christchurch, 8081, New Zealand, Tel +64 21 02361114, Email richard.milne@hoa.co.nzPurpose: To estimate the 5-year budget impact to Aotearoa New Zealand (NZ) hospitals of domiciliary nasal high flow (NHF) therapy to patients with chronic obstructive pulmonary disease (COPD) who require long term oxygen therapy.Methods: Hospital admission counts along with length of stay were obtained from hospital records of 200 COPD patients enrolled in a 12-month randomized clinical trial of NHF in Denmark, both over a 12-month baseline and then in the study period while on randomized treatment (control or NHF). NZ costings from similar COPD patients were estimated using data from Middlemore Hospital, Auckland and were applied to the Danish trial. The budget impact of NHF was estimated over the predicted 5-year lifetime of the device when used by patients sequentially.Results: Fifty-five of 100 patients in the NHF group and 44 of 100 patients in the control group were admitted to hospital with a respiratory diagnosis during the baseline year. They had 108 admissions in the treatment group vs 89 in the control group, with 632 vs 438 days in hospital, and modeled annual costs of $9443 vs $6512 per patient, respectively. During the study period there were 38 vs 44 patients with 67 vs 80 admissions and 302 vs 526 days in hospital, at a modeled annual cost of $6961 vs $9565 per patient respectively. Taking into account capital expenditure and running costs, this resulted in cost savings of $5535 per patient-year (95% CI, -$36 to -$11,034). With 90% usage over the estimated five-year lifetime of the NHF device, amortized capital costs of $594 per year and annual running costs of $662, we estimate a 5-year undiscounted cost saving per NHF device of $18,626 ($16,934 when discounted to net present value at 5% per annum). There would still be annual cost savings over a wide range of assumptions.Conclusion: Domiciliary NHF therapy for patients with severe COPD has the potential to provide substantial hospital cost savings over the five-year lifetime of the NHF device.Keywords: cost, hospital admissions, nasal high flow, COPD, long term oxygen therapy, LTOT, budget impact, New Zealand |
| first_indexed | 2024-04-13T20:01:12Z |
| format | Article |
| id | doaj.art-68610f004fc1494b87abca582f547bbe |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-13T20:01:12Z |
| publishDate | 2022-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-68610f004fc1494b87abca582f547bbe2022-12-22T02:32:12ZengDove Medical PressInternational Journal of COPD1178-20052022-06-01Volume 171311132275725Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow TherapyMilne RJHockey HUGarrett JRichard J Milne,1,2 Hans-Ulrich Hockey,3 Jeffrey Garrett4 1Health Outcomes Associates Ltd, Auckland, New Zealand; 2School of Pharmacy, University of Auckland, Auckland, New Zealand; 3Biometrics Matters Ltd, Hamilton, New Zealand; 4Middlemore Hospital, Auckland, New ZealandCorrespondence: Richard J Milne, Health Outcomes Associates Ltd, 260 Major Hornbrook Road, Christchurch, 8081, New Zealand, Tel +64 21 02361114, Email richard.milne@hoa.co.nzPurpose: To estimate the 5-year budget impact to Aotearoa New Zealand (NZ) hospitals of domiciliary nasal high flow (NHF) therapy to patients with chronic obstructive pulmonary disease (COPD) who require long term oxygen therapy.Methods: Hospital admission counts along with length of stay were obtained from hospital records of 200 COPD patients enrolled in a 12-month randomized clinical trial of NHF in Denmark, both over a 12-month baseline and then in the study period while on randomized treatment (control or NHF). NZ costings from similar COPD patients were estimated using data from Middlemore Hospital, Auckland and were applied to the Danish trial. The budget impact of NHF was estimated over the predicted 5-year lifetime of the device when used by patients sequentially.Results: Fifty-five of 100 patients in the NHF group and 44 of 100 patients in the control group were admitted to hospital with a respiratory diagnosis during the baseline year. They had 108 admissions in the treatment group vs 89 in the control group, with 632 vs 438 days in hospital, and modeled annual costs of $9443 vs $6512 per patient, respectively. During the study period there were 38 vs 44 patients with 67 vs 80 admissions and 302 vs 526 days in hospital, at a modeled annual cost of $6961 vs $9565 per patient respectively. Taking into account capital expenditure and running costs, this resulted in cost savings of $5535 per patient-year (95% CI, -$36 to -$11,034). With 90% usage over the estimated five-year lifetime of the NHF device, amortized capital costs of $594 per year and annual running costs of $662, we estimate a 5-year undiscounted cost saving per NHF device of $18,626 ($16,934 when discounted to net present value at 5% per annum). There would still be annual cost savings over a wide range of assumptions.Conclusion: Domiciliary NHF therapy for patients with severe COPD has the potential to provide substantial hospital cost savings over the five-year lifetime of the NHF device.Keywords: cost, hospital admissions, nasal high flow, COPD, long term oxygen therapy, LTOT, budget impact, New Zealandhttps://www.dovepress.com/hospital-cost-savings-for-sequential-copd-patients-receiving-domicilia-peer-reviewed-fulltext-article-COPDcosthospital admissionsnasal high flowcopdlong term oxygen therapy (ltot)budget impactnew zealand |
| spellingShingle | Milne RJ Hockey HU Garrett J Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy International Journal of COPD cost hospital admissions nasal high flow copd long term oxygen therapy (ltot) budget impact new zealand |
| title | Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy |
| title_full | Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy |
| title_fullStr | Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy |
| title_full_unstemmed | Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy |
| title_short | Hospital Cost Savings for Sequential COPD Patients Receiving Domiciliary Nasal High Flow Therapy |
| title_sort | hospital cost savings for sequential copd patients receiving domiciliary nasal high flow therapy |
| topic | cost hospital admissions nasal high flow copd long term oxygen therapy (ltot) budget impact new zealand |
| url | https://www.dovepress.com/hospital-cost-savings-for-sequential-copd-patients-receiving-domicilia-peer-reviewed-fulltext-article-COPD |
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