Cost Effectiveness Analysis of Home-Based Phototherapy Versus Hospital-Based Phototherapy for Treatment of Neonatal Hyperbilirubinemia in shiraz, Iran

Background: Neonatal jaundice is the most common cause of hospitalization of mature and healthy infants. Phototherapy is the most common treatment for the rise in indirect bilirubin. Hospitalization of infants has complications such as hospital infections, separation of the mother from the baby, occupying hospital beds and high cost of hospitalization. Since phototherapy is possible at home and by home care centers, this study was conducted to analyze the cost-effectiveness of phototherapy at home versus phototherapy in hospital in Shiraz in 2021. Methods This research is a complete economic evaluation of cost-effectiveness that was conducted cross-sectionally from March to August 2021 in Hafez and Hazrat Zeinab hospitals and Parseh and Ava Gostar home care centers in Shiraz. The study population included all neonates who were admitted to these centers with a diagnosis of jaundice for phototherapy. 180 neonates with jaundice in the two groups of hospital and home care were included in the study. The effectiveness index for this study was the average daily decrease in total bilirubin. We made use of cost and effectiveness forms to collect the required information. The results were presented in the form of incremental cost-effectiveness ratio (ICER) and one-way and probabilistic sensitivity analysis was used to measure the strength of the study results. TreeAge pro2020, Excel 2019 and Spss18 were used to analyze the collected data. Results The results showed that the average cost of phototherapy at home and hospital were $ 196.52 and $ 397.85, respectively, and the average effectiveness was 0.39 and 0.36, respectively. Therefore, according to the results, phototherapy at home is more cost-effective than phototherapy in the hospital. In addition, the results of one-way and probabilistic sensitivity analysis showed the strength of the research results. Conclusion Phototherapy at home is a more cost-effective option than phototherapy in the hospital. Therefore, it can be suggested to insurance organizations as well as service providers to prioritize phototherapy at home to be included in the basic insurance package.