TABLE 3.
Expected annual changes in disability‐adjusted life years (DALYs) and costs if standard primary care management of acute respiratory infection was supplemented with pulse oximetry in the in Mueang Chiang Rai district, Thailand for the cohort of patients in this study
| Main analysis | Sensitivity analysis 1 | Sensitivity analysis 2 | Sensitivity analysis 3 | Sensitivity analysis 4 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient category | DALYs averted per year (main analysis and sensitivity analysis 2) | DALYs averted per year (sensitivity analyses 1, 3 and 4) | Total cost savings per year, US$ | Antibiotic cost savings per year, US$ | Total cost savings per year, US$ | Antibiotic cost savings per year, US$ | Total cost savings per year, US$ | Antibiotic cost savings per year, US$ | Total cost savings per year, US$ | Antibiotic cost savings per year, US$ | Total cost savings per year, US$ | Antibiotic cost savings per year, US$ |
| Children <5 years (n = 14,075) | 2.0 | 0.4 | 12,757 | 11,651 | 5972 | 11,651 | 18,906 | 286 | 5184 | 286 | 4902 | 0 |
| Children 5–14 years (n = 11,741) a | 0.7 | 0.2 | 24,849 | 14,915 | 22,179 | 14,915 | 17,403 | 534 | 11,924 | 534 | 11,395 | 0 |
| Adults (n = 24,142) a | 0.9 | 0.2 | 52,944 | 31,801 | 47,258 | 31,801 | 37,399 | 1480 | 25,897 | 1480 | 24,429 | 0 |
|
All patients (n = 49,958) |
3.7 | 0.8 | 90,550 | 58,367 | 75,408 | 58,367 | 73,708 | 2300 | 43,004 | 2300 | 40,727 | 0 |
Note: Monetary values are expressed in US dollars as at 1 August 2021 rounded to the nearest dollar. Sensitivity analysis 1 used the same parameters as the main analysis but with a lower clinical sensitivity and specificity for diagnosis of severe lower respiratory tract infections with pulse oximetry plus clinical assessment of 70% and 85%, respectively and with the mortality benefits halved. Sensitivity analysis 2 used the sensitivity and specificity values as the main analysis, but with no reduction in the median hospital length of stay of admitted patients, a lower reduction in antibiotic prescriptions of 25% in each category, and no cost of antibiotic resistance. Sensitivity analysis 3 combined the increased costs in sensitivity analysis 2 with the reduced number of DALYs averted in sensitivity analysis 1. Sensitivity analysis 4 combined the increased costs and reduced number of DALYs averted in sensitivity analysis 3, and assumed no reduction in antibiotic prescribing for upper respiratory tract infections.
Equipment and training costs of pulse oximetry were not included in the calculation of total cost savings for children 5–14 years and adults as these costs would have been incurred with the implementation of pulse oximetry for children <5 years.