Cost-effectiveness analysis of nasojejunal tube feeding for the prevention of pneumonia in adults who are critically ill

© 2021 American Society for Parenteral and Enteral Nutrition..

BACKGROUND: Nasojejunal tube (NJT) feeding has demonstrated value in reducing pneumonia in adults who are critically ill who require enteral nutrition (EN) support. This study discusses whether EN support via NJT feeding is more cost-effective than nasogastric tube (NGT) feeding in reducing pneumonia.

METHODS: A decision-tree model was created. The analysis was based on data from a health care provider in China. Model inputs were derived from published data. The end points included incremental cost per pneumonia infection avoided, incremental cost-effectiveness ratio (ICER), net monetary benefit (NMB), and incremental NMB (INMB) associated with prevention of pneumonia. The uncertainty was assessed through one-way and probabilistic sensitivity analysis.

RESULTS: The base case analysis showed that EN support via NJT feeding resulted in 0.7453 quality-adjusted life years (QALYs) at a cost of $3018.83 compared with NGT feeding, which resulted in 0.7354 QALYs at a cost of $4788.76. NJT feeding was better than NGT feeding, providing an INMB of $2075.09 and an ICER of -$178,813.96 per QALY gained, and the cost per pneumonia infection prevented was $16,808.51. The probabilistic sensitivity analysis indicated that NJT feeding was more cost-effective in 83.4% of the cases, with a cost below the WTP threshold. The NMB and INMB estimation for different WTP thresholds also indicated that NJT feeding is the optimal strategy.

CONCLUSIONS: EN support via NJT feeding was a more cost-effective strategy than NGT feeding in preventing pneumonia in adults who are critically ill.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:46

Enthalten in:

JPEN. Journal of parenteral and enteral nutrition - 46(2022), 5 vom: 05. Juli, Seite 1167-1175

Sprache:

Englisch

Beteiligte Personen:

Wang, Hongmei [VerfasserIn]
Huang, Chun [VerfasserIn]
Yang, Yang [VerfasserIn]
Kong, Lingxi [VerfasserIn]
Zheng, Xiaoying [VerfasserIn]
Shan, Xuefeng [VerfasserIn]

Links:

Volltext

Themen:

Cost-effectiveness
Enteral nutrition
Journal Article
Nasogastric tube feeding
Nasojejunal tube feeding
Pneumonia

Anmerkungen:

Date Completed 13.07.2022

Date Revised 20.07.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/jpen.2302

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM332899616