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Economic Evaluation of Small Bowel Transplantation in Paediatrics


Project description

Brief Summary Objectives: To evaluate the cost-effectiveness of intestinal transplantation (isolated small bowel or combined small bowel and liver transplantation) in children with chronic intestinal failure.

Methods: Prospective study of patients assessed for a small bowel transplant at Birmingham Children’s Hospital. Two main groups emerged from the study: those that received a transplant during the study period and those patients who remain on parenteral nutrition and do not receive a transplant. The perspective of the study was the NHS. All health service resources used during assessment, candidacy, transplant and post-transplant were recorded and costed. Patients were followed up for thirty months from their first assessment or until death.   Two approaches were taken in estimating the cost-effectiveness of small bowel transplantation:
  1.       Cost-effectiveness of transplanted patients is estimated by comparison with the costs and outcomes of the same patients in the absence of transplantation using a prognostic model to predict survival without transplant.    
  2.       Cost-effectiveness was estimated in an ‘intent to transplant’ analysis, comparing the costs and outcomes of transplanted patients to a control group consisting of data relating the waiting list experiences of all patients listed for a transplant.    
Main collaborators: Dr Susan Beath and Dr Deirdre Kelly (Birmingham Children’s Hospital) Reports:   Longworth L, Young T, Mistry H, Ratcliffe J and Buxton M (October 2003) An economic evaluation of small bowel transplantation for paediatric patients. Department of Health Report.