Journal of Pediatric Orthopaedics 2009;29:558–563
Background: The purpose of this study was to determine the efects of clinical gait analysis (GA) on the costs of care in ambulatory children with cerebral palsy (CP) and the amount of surgery these children undergo.
Conclusions: Clinical GA is associated with a lower incidence of additional surgery, resulting in lesser disruption to patients’ lives. This ﬁnding has not been shown before and may assist patients, physicians, policy makers, and insurance companies in assessing the role of GA in the care of ambulatory children with CP.
Thesis submitted to the School of Economics, The University of Queensland, in partial fulfilment of the requirements for the degree of Masters of Health Economics (Advanced)
Autor: Keshwa Nand Reddy
BA, PGDEco (USP)
Agradecimentos a Keshwa Nand Reddy e a Dra. Robyn Grote pela cessão do arquivo digital desta obra.
This research is concerned exclusively with children who are suffering from gait related abnormalities. The purpose of this thesis was to conduct an economic evaluation of alternative means of treating gait. More specifically, the answer to the following was sought: “which method of treating cerebral palsy (clinical gait analysis or the current method of clinical observation) maximises the difference between social benefits and social costs?” The technique of cost-benefit analysis was employed to answer this question.
In order to conduct an economic evaluation, information on the marginal costs and benefits of conducting gait analyses was estimated using data obtained from the Royal Children’s Hospital in Brisbane. Of the 15 patients identified for the study, 10 responses were obtained. Three of six physicians who were approached for the study responded to the questionnaire. Of the ten respondents, six either had their treatment options changed or deferred, three had no changes but wanted confirmation and one had CGA to assure family of the initial diagnosis by the physician. Results of the analysis of the raw data suggest that the marginal benefits of conducting clinical gait analysis are greater than its marginal costs. The bootstrapping technique used also used to simulate a larger sample (of 2000 iterations) and the results also confirmed the initial finding.