The impact of time to diagnosis on health service use, cost, and quality of life for patients with juvenile idiopathic arthritis: a cost-utility analysis
Authors' conclusion
Interventions to improve the time to diagnosis of JIA within six months are likely cost-effective and can significantly improve HRQoL for people living with JIA.
Study context
- Population
- Children with Juvenile Idiopathic Arthritis (JIA); healthcare use and time to diagnosis from The IMPACT Survey, Australia
- Participants
- 163 children
- Comparison
- Time from actively seeking treatment to formal diagnosis of JIA: < 6 months vs 6 + months
- 6 + monthsn = 61reference
- Outcome
- Health service use, HRQoL (CHU9D) and associated healthcare costs; incremental QALYs
- Follow-up
- Lifetime
Methodological detailslifetime horizon, health funder perspective, 2023 Australian dollars, costs and Quality Adjusted Life Years (QALYs) present valued at 5% per annum, sensitivity analyses
- Lifetime horizon
- Health funder perspective
- 2023 Australian dollars
- Costs and QALYs present valued at 5% per annum
- Sensitivity analyses
Main finding
As reported in the abstract
Present value of healthcare cost savings per child over a lifetime, timely diagnosis
$208,458
95%CI $45,388, $371,528
Additional QALYs per child over a lifetime from increased health-related quality of life (HRQoL)
2.82
95%CI 1.03, 4.61
Estimated net benefit to health funder per child at WTP $50,000 per QALY
$349,520
95%CI $139,630, $559,411
Further findings
HRQoL (CHU9D utility value), diagnosis within 6 months vs 6+ months
- Significant increase in HRQoL utility value with timely diagnosis
- 0.14 (95%CI 0.05, 0.23)
Annual healthcare funder costs, diagnosis within 6 months vs 6+ months
- Mean annual decrease in costs for the healthcare funder per child with diagnosis within 6 months
- more than $10,000
- Most cost savings from fewer hospitalizations for pain, inflammation and investigative procedures
Persistence of differences in health service use and HRQoL · 20 years from diagnosis
- Differences from timely diagnosis persisted over 20 years from diagnosis
Original publication
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