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https://hdl.handle.net/2440/126095
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Type: | Journal article |
Title: | Costs and uptake of a community model of paediatric food allergy care versus specialist hospital care: A before-and-after controlled trial |
Author: | Hiscock, H. Perera, P. Tang, M.L.K. Danchin, M.H. Sung, V. Karnon, J. |
Citation: | Journal of Paediatrics and Child Health, 2020; 56(8):1225-1232 |
Publisher: | Wiley |
Issue Date: | 2020 |
ISSN: | 1034-4810 1440-1754 |
Statement of Responsibility: | Harriet Hiscock, Prescilla Perera, Mimi LK Tang, Margaret H Danchin, Valerie Sung, and Jonathan Karnon |
Abstract: | AIM: To compare the costs of community-based food allergy model of care (intervention cohort, IC) with a tertiary-hospital, specialist allergy clinic model of care (control cohort, CC). METHODS: In this pragmatic controlled trial, children (aged 0-12 years) newly referred to the allergy clinic at Melbourne's Royal Children's Hospital with suspected/known food allergy to three or fewer foods were allocated to see either a community-based paediatrician, trained via online webinars and web-based clinical decision support tools for food allergy diagnosis and management, or a hospital allergist. Per-patient costs to the health-care system and out-of-pocket costs to families seen within 12 months (clinician time, allergy tests and medicare billing) were compared between the two models of care. RESULTS: At 12 months, 54/181 (30%) CC families had been seen in the allergy clinic and 93/115 (81%) of the IC families who chose to see a community paediatrician had been seen. In an intention-to-treat analysis (ITT), health-care system costs per IC patient were higher than the costs per CC patient (mean cost $333 versus $319, respectively; mean difference $14, 95% Confidence Interval (CI) -97 to 118, P = 0.81). Total out-of-pocket costs to family were $129 in the IC compared with $89 in the CC (mean difference $40, 95% CI $4-$77, P = 0.03). CONCLUSIONS: A community-based model of care for simple food allergy showed that costs to the health-care system were similar between the community model and hospital care but did not show reduced out-of-pocket costs to the families 12-months post-enrolment. |
Keywords: | children community food allergy care model paediatrician |
Rights: | © 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) |
DOI: | 10.1111/jpc.14905 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1125687 http://purl.org/au-research/grants/nhmrc/1136222 |
Published version: | http://dx.doi.org/10.1111/jpc.14905 |
Appears in Collections: | Aurora harvest 8 Public Health publications |
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