{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:11:13Z","timestamp":1789603873147,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1104527"],"award-info":[{"award-number":["APP1104527"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Febrile neutropenia (FN) in children with cancer generally requires in\u2010hospital care, but low\u2010risk patients may be successfully managed in an outpatient setting, potentially reducing the overall healthcare costs. Updated data on the costs of FN care are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A bottom\u2010up microcosting analysis was conducted from the healthcare system perspective using data collected alongside the Australian PICNICC (Predicting Infectious Complications of Neutropenic sepsis In Children with Cancer) study. Inpatient costs were accessed from hospital administrative records and outpatient costs from Medicare data. Costs were stratified by risk status (low\/high risk) according to the PICNICC criteria. Estimated mean costs were obtained through bootstrapping and using a linear model to account for multiple events across individuals and other clinical factors that may impact costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total costs of FN care were significantly higher for FN events classified as high\u2010risk ($17,827, 95% confidence interval [CI]: $17,193\u2013$18,461) compared to low\u2010risk ($10,574, 95% CI: $9818\u2013$11,330). In\u2010hospital costs were significantly higher for high\u2010risk compared to low\u2010risk events, despite no differences in the cost structure, mean cost per day, and pattern of resource use. Hospital length of stay (LOS) was the only modifiable factor significantly associated with total costs of care. Excluding antineoplastics, antimicrobials are the most commonly used medications in the inpatient and outpatient setting for the overall period of analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The FN costs are driven by in\u2010hospital admission and LOS. This suggests that the outpatient management of low\u2010risk patients is likely to reduce the in\u2010hospital cost of treating an FN event. Further research will determine if shifting the cost to the outpatient setting remains cost\u2010effective overall.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30633","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:07:01Z","timestamp":1692637621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["An analysis of the resource use and costs of febrile neutropenia events in pediatric cancer patients in Australia"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-1926","authenticated-orcid":false,"given":"Constanza","family":"Vargas","sequence":"first","affiliation":[{"name":"Centre for Health Economics Research and Evaluation University of Technology Sydney  Broadway New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle M.","family":"Haeusler","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"},{"name":"The Paediatric Integrated Cancer Service Victoria State Government  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A.","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-9673","authenticated-orcid":false,"given":"Robert","family":"Phillips","sequence":"additional","affiliation":[{"name":"Centre for Reviews and Dissemination University of York  York UK"},{"name":"Leeds Children's Hospital Leeds General Infirmary  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Thursky","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"},{"name":"Victorian Infectious Diseases Service The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria 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