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Flu vaccination in pediatric ED cost-effective
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Offering influenza vaccination to all patients in a pediatric ED was cost-effective, saving an estimated $33.51 per patient compared with not offering the vaccine at all, according to a study published in JAMA Pediatrics.
“The ED may help increase coverage [of the influenza vaccine] specifically because it serves as a location where patients are already presenting for care, often for relatively low-acuity complaints and illnesses like ear infections and sports injuries,” Rebecca J. Hart, MD, from the division of pediatric emergency medicine at the University of Louisville, said in an interview with Infectious Disease News. “If lack of time is a significant barrier to parents obtaining the vaccine for their children, then eliminating the need to make a separate doctor or clinic visit to obtain the vaccine may be particularly helpful.”
Hart and colleagues evaluated four strategies for administering influenza immunizations at a tertiary, urban, freestanding, pediatric ED that serves nearly 60,000 visitors annually. These included:
The researchers conducted a cost-effectiveness analysis of all four approaches from Jan. 1, 2016, to June 1, 2017. They used sensitivity analyses to account for a range of “uncertainties,” including the prevalence of influenza, the price of vaccine and its effectiveness, and the costs of complications.
The lowest cost was observed in the scenario in which all eligible patients received the vaccine, with $114.45 saved per case avoided (95% CI, $55.48-$245.45). Compared with no vaccinations, this strategy saves $33.51 per case (95% CI, $18-$62) and can reduce the number of influenza cases by 27 per 1,000 patients.
Offering the vaccine to all pediatric ED visitors resulted in 0.72 days (95% CI, 0.18-1.78) of quality-adjusted life years lost. This number was higher when vaccination was not offered (0.91 days lost; 95% CI, 0.25-2.2). Additionally, the strategy of offering the vaccine to all patients in the pediatric ED remained “robustly” cost-effective in sensitivity analyses, the researchers said.
Hart and colleagues also noted that routine influenza vaccination in the pediatric ED results in a net social monetary benefit in many instances. In a Monte Carlo analysis, offering the vaccine to all patients demonstrated superiority over 99.8% of other strategies.
“Vaccinating children in the ED may be simpler than anticipated,” Hart said. “While initial start-up costs may be an issue for some centers, we used stock of vaccine that was already supplied for the hospital and kept costs relatively low. Based on the findings of the study, the vaccine program is cost-effective even if an individual center has higher administrative costs than we did.” – by Katherine Bortz
- Reference:
- Hart RJ, et al. JAMA Pediatr. 2017;doi:10.1001/jamapediatrics.2017.3879.
Disclosures: The authors report no relevant financial disclosures.