ECONOMIC-ASPECTS OF TREATMENT OF CYSTIC-F IBROSIS WITH CHRONIC PULMONARY PSEUDOMONAS INFECTION

Background: Due to limited resources within the health service and the continuous discussion on cost containment, economic criteria should a lso be considered when assessing therapy concepts. Particular results in terms of economic efficiency reserves are to be expected from a tra nsfer of care from the in-patient to the out-patient sector. Methods: In a prospective, direct cost recording of all relevant uses of resour ces, the direct and indirect costs of the treatment of 14 patients wit h cystic fibrosis (CF) were included in the cross-over-design. The qua lity of life was recorded at least once for each patient using the Eur oQol. In-patient intravenous antibiotic therapy carried out during the block of out-patient care served as one of the disqualification crite ria when selecting patients. Result: Over an observation period of nin e months, the average direct cost recorded were DM 35,706 for out-pati ent and DM 40,143 for in-patient treatment (+15%). As far as indirect costs are concerned, the losses of production in the national economy recorded for in-patient treatment were 80% higher. Conclusion: The dir ect and indirect costs for in-patient CF-therapy are in total higher t han for out-patient care. Whether these cost advantages have to be ''b ought'' with lower medical effectiveness needs to be demonstrated by f urther clinical studies. In the sense of the disease management approa ch, the results of this study should be used to help rationally weigh up the costs of out-patient care against alternative treatment concept s.