4.6 Article

Zinc supplementation reduced cost and duration of acute diarrhea in children

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JOURNAL OF CLINICAL EPIDEMIOLOGY
卷 60, 期 6, 页码 560-566

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2006.08.004

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oral rehydration solution; incremental cost effectiveness ratio; cost effectiveness analysis; zinc; diarrhea

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Objective: To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. Study Design and Setting: Cost-effectiveness analysis among patients consulting the emergency room of a government institution. Method: Cost of treatment and outcome of participants of a randomized trial of zinc + ORS vs. ORS alone for acute diarrhea were investigated. Included were subjects 2-59 months with diarrhea < 7 days and no dehydration. The direct medical, nonmedical and indirect costs were obtained, using the societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Results: Sixty patients were given zinc + ORS and 57 were given ORS alone. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ORS group The ICER showed that with use of zinc, the society saves $ 2.4 per day of diarrhea < 4 days and spends $ 0.03 per case of diarrhea averted < 4 days from consult, although the confidence interval included the null value of zero. Conclusion: Use of zinc with ORS reduced the total cost and duration of acute diarrhea. The ICER suggests cost effectiveness of zinc supplementation but there is a need to further assess the role of zinc supplementation in a larger population. (c) 2007 Elsevier Inc. All rights reserved.

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