Economic evaluation of enhanced oral care in reducing the incidence of non-ventilator hospital-acquired pneumonia.
Pakhi Sharma, Nicole M White, Nicholas Graves et al.
✦ AI-curated · Sources linked
In 30 seconds
This within-trial economic evaluation of the cluster randomised HAPPEN trial assessed enhanced oral care versus usual care across three Australian hospitals, from a hospital perspective. In a modelled cohort of 1000 patients, intervention costs were AUD$11,996,000 versus AUD$12,148,000 with usual care after accounting for bed-days saved. The intervention was estimated to save AUD$152 and gain 0.02 QALY per patient, making it dominant. Incremental net monetary benefit was AUD$642 (95% uncertainty interval AUD$42 to AUD$1591) per patient, with approximately 98% probability of cost-effectiveness at the AUD$28,000 per QALY threshold.
Key findings
- For 1000 patients, estimated costs were AUD$11,996,000 with enhanced oral care and AUD$12,148,000 with usual care.
- The intervention was estimated to save AUD$152 and gain 0.02 QALY per patient.
- Incremental net monetary benefit was AUD$642 (95% uncertainty interval AUD$42 to AUD$1591) per patient.
- At the AUD$28,000 per QALY threshold, the intervention had approximately 98% probability of being cost-effective.
Why it matters
Non-ventilator hospital-acquired pneumonia contributes to hospital costs and is a target for prevention. This evaluation suggests that enhanced oral care may reduce costs while improving quality-adjusted survival, supporting consideration of oral care within infection-prevention planning. The economic findings are based on trial data and modelling, so they inform resource decisions rather than establishing universal cost savings.
What to keep in mind
The evaluation was conducted from a hospital perspective across three Australian hospitals and used a decision-analytic model with trial and published-literature inputs.