The NHS costs of diagnostic uncertainty surrounding paediatric febrile illness

  • Leigh S & al.
  • BMC Med
  • 6 Mar 2019

  • curated by Dawn O'Shea
  • UK Medical News
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The economic impact of diagnostic uncertainty around the diagnosis and management of paediatric febrile illness is significant, and the precautionary use of antibiotics is a large contributor, according to research by the University of Liverpool and Liverpool School of Tropical Medicine.

The study included data from an all-year prospective, comprehensive, and representative cohort of 6518 febrile children (aged

The economic impact of managing paediatric febrile illness was estimated, with focus on nurse/clinician time, investigations, radiography and inpatient stay. The patient and health care provider characteristics associated with increased resource use were identified.

Analysis revealed that febrile illness in infants aged

Approximately 32.4% of children received antibiotics. Bacterial infections were diagnosed in 7.05%. Children with viral illnesses receiving antibiotics incurred 9.9-fold cost increases (95% CI, 6.5-13.2) compared to those not receiving antibiotics. The cost increase predominantly resulted in a 53.9-hour increase in observation and inpatient stay (57.1 vs 3.2).

Treatment by less experienced doctors was associated with 3.2-fold (95% CI, 2.0-5.1) higher resource use than consultants (P<.001>

The authors concluded that, based on the data, “any advances in diagnostic capabilities, including molecular diagnostics, protein biomarkers, and point of care tests would likely yield the potentially greatest efficiency gains in these groups of children, as among these the perceived risks of untimely diagnosis are greatest”.

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