London School of Hygiene & Tropical Medicine

Gastrostomy placement is cost effective and has positive benefits for children who are neurologically impaired, according to a study published today in the Archives of Disease in Childhood.

Children who are neurologically impaired tend to suffer from malnutrition and restricted growth. The cost of their health care is high and looking after them can be demanding and stressful for parents and carers.

The team had already established in a clinical study, that gastrostomy placement had led to significant catch up weight, reduce drooling and vomiting and lessen the stress and demand placed on a child's family and carers. However, the cost-effectiveness of the procedure had not been investigated.

A economic study led by Professor Joy Townsend of the London School of Hygiene & Tropical Medicine, working with colleagues at the Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust in London and La Trobe University in Melbourne, Australia, estimated the costs of hospital care, including surgery, community and private health care and the cost of food, before and after surgery. They estimated costs by carrying out a prospective controlled study of children referred to a tertiary paediatric centre in the UK.

While average overall costs were unaffected, community costs were found to be significantly lower after surgery.

The authors conclude that gastrostomy placement in these children resulted in significant clinical benefit at no significant extra cost, and that the procedure is cost-effective in this group of children.

• Cost effectiveness of gastrostomy placement for children with neuro-developmental disability: JL Townsend, MSc, PhD, London School of Hygiene & Tropical Medicine, London, UK; G Craig, MSc PhD Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK; M Lawson PhD, RD Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK; S Reilly, PhD, La Trobe University, Melbourne, Australia; L Spitz PhD FRCS Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK.