Abstract：
BACKGROUND: Infectious conjunctivitis affects 1 in 8 children annually, resulting in high ophthalmic antibiotic prescribing and absenteeism from childcare and school. We aimed to quantify the cost-effectiveness and annual savings of 3 evidence-based approaches to conjunctivitis management and return to childcare and school compared to usual care.
METHODS: Using a decision analytic model from a societal perspective over a 1-year time horizon, we conducted a cost-effectiveness analysis of 3 management strategies for children aged 6 months to 17 years with non-severe conjunctivitis compared to usual care in the United States. Strategies accounted for rate of transmission. Strategies included (1) refraining from prescribing ophthalmic antibiotics for non-severe conjunctivitis, (2) allowing children without systemic symptoms to attend childcare and school, (3) and the combined approach of refraining from prescribing ophthalmic antibiotics and allowing children without systemic symptoms to attend childcare and school.
RESULTS: The estimated annual expenditure for pediatric conjunctivitis was $1.95 billion. Usual care was the most expensive ($212.73/episode), followed by refraining from ophthalmic antibiotic prescribing ($199.92) and allowing children without systemic symptoms to attend childcare and school ($140.18). The combined approach was the least costly ($127.38). Disutility was similar between approaches (quality-adjusted life days 0.271 vs 0.274). Refraining from antibiotic prescribing and the combination approach were dominant compared to usual care. The combined approach resulted in an estimated $783 million annual savings and 1.6 million ophthalmic antibiotic courses averted.
CONCLUSIONS: Conjunctivitis poses an economic burden that could be reduced by refraining from ophthalmic antibiotic use and allowing children without systemic symptoms to remain at school or childcare.
METHODS: Using a decision analytic model from a societal perspective over a 1-year time horizon, we conducted a cost-effectiveness analysis of 3 management strategies for children aged 6 months to 17 years with non-severe conjunctivitis compared to usual care in the United States. Strategies accounted for rate of transmission. Strategies included (1) refraining from prescribing ophthalmic antibiotics for non-severe conjunctivitis, (2) allowing children without systemic symptoms to attend childcare and school, (3) and the combined approach of refraining from prescribing ophthalmic antibiotics and allowing children without systemic symptoms to attend childcare and school.
RESULTS: The estimated annual expenditure for pediatric conjunctivitis was $1.95 billion. Usual care was the most expensive ($212.73/episode), followed by refraining from ophthalmic antibiotic prescribing ($199.92) and allowing children without systemic symptoms to attend childcare and school ($140.18). The combined approach was the least costly ($127.38). Disutility was similar between approaches (quality-adjusted life days 0.271 vs 0.274). Refraining from antibiotic prescribing and the combination approach were dominant compared to usual care. The combined approach resulted in an estimated $783 million annual savings and 1.6 million ophthalmic antibiotic courses averted.
CONCLUSIONS: Conjunctivitis poses an economic burden that could be reduced by refraining from ophthalmic antibiotic use and allowing children without systemic symptoms to remain at school or childcare.
摘要：
背景：感染性结膜炎每年影响八分之一的儿童，导致高眼抗生素处方和儿童保育和学校缺勤。我们旨在量化与常规护理相比，三种基于证据的结膜炎管理方法以及返回托儿和学校的成本效益和年度节省。
方法：在一年的时间范围内，从社会角度使用决策分析模型，我们对6个月-17岁非重度结膜炎儿童的3种治疗策略进行了成本-效果分析,与美国常规治疗相比.策略占传播率。策略包括1）避免处方非严重结膜炎的眼科抗生素，2）允许没有全身症状的儿童参加托儿和学校，3）以及避免开眼科抗生素处方并允许没有全身症状的儿童参加托儿和学校的联合方法。
结果：估计儿科结膜炎的年度支出为19.5亿美元。通常的护理是最昂贵的（每集212.73美元），随后避免使用眼科抗生素处方（199.92美元），并允许无全身症状的儿童参加托儿服务和学校（140.18美元）。合并方法成本最低（127.38美元）。不同方法之间的无效性相似（质量调整后的生命天数0.271v0.274）。与常规治疗相比，避免抗生素处方和联合治疗方法占主导地位。综合方法估计每年节省7.83亿美元，避免了160万次眼科抗生素疗程。
结论：结膜炎带来的经济负担可以通过避免使用眼科抗生素和允许无全身症状的儿童留在学校或托儿所来减轻。
方法：在一年的时间范围内，从社会角度使用决策分析模型，我们对6个月-17岁非重度结膜炎儿童的3种治疗策略进行了成本-效果分析,与美国常规治疗相比.策略占传播率。策略包括1）避免处方非严重结膜炎的眼科抗生素，2）允许没有全身症状的儿童参加托儿和学校，3）以及避免开眼科抗生素处方并允许没有全身症状的儿童参加托儿和学校的联合方法。
结果：估计儿科结膜炎的年度支出为19.5亿美元。通常的护理是最昂贵的（每集212.73美元），随后避免使用眼科抗生素处方（199.92美元），并允许无全身症状的儿童参加托儿服务和学校（140.18美元）。合并方法成本最低（127.38美元）。不同方法之间的无效性相似（质量调整后的生命天数0.271v0.274）。与常规治疗相比，避免抗生素处方和联合治疗方法占主导地位。综合方法估计每年节省7.83亿美元，避免了160万次眼科抗生素疗程。
结论：结膜炎带来的经济负担可以通过避免使用眼科抗生素和允许无全身症状的儿童留在学校或托儿所来减轻。
