In this issue of AJDC, Listernick and co-workers present an important report on the efficacy and cost savings of an oral rehydration regimen for infants who were dehydrated as a result of gastroenteritis.1 They add to the burgeoning literature on this technique in two ways: they describe the use of oral hydration in dehydrated infants who are managed as outpatients in the United States, and they assess the cost-effectiveness of this approach. Much has been written of the former; the latter has just begun to enter many physicians' consciousness in day-to-day reality.
As this manuscript was revised, considerable discussion emerged as to whether the emphasis was misplaced, ie, were we now looking at cost-effectiveness and not at the "best" method for treating a specific condition? The authors acknowledge this controversy by stating, "Cost containment should be an integral part of medical care, although never at the expense of either
FULGINITI VA. Efficacy and Cost Containment: Inseparable Factors in Diagnostic and Therapeutic Decisions. Am J Dis Child. 1986;140(3):199–200. doi:10.1001/archpedi.1986.02140170025020
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