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Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations

OBJECTIVE: The aim of this review was to summarise the current evidence on the costing of resource use within UK maternity care, in order to facilitate the estimation of incremental resource and cost impacts potentially attributable to maternity care interventions. METHODS: A systematic review of ec...

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Autores principales: Relph, Sophie, Delaney, Louisa, Melaugh, Alexandra, Vieira, Matias C, Sandall, Jane, Khalil, Asma, Pasupathy, Dharmintra, Healey, Andy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604861/
https://www.ncbi.nlm.nih.gov/pubmed/33127635
http://dx.doi.org/10.1136/bmjopen-2020-040022
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author Relph, Sophie
Delaney, Louisa
Melaugh, Alexandra
Vieira, Matias C
Sandall, Jane
Khalil, Asma
Pasupathy, Dharmintra
Healey, Andy
author_facet Relph, Sophie
Delaney, Louisa
Melaugh, Alexandra
Vieira, Matias C
Sandall, Jane
Khalil, Asma
Pasupathy, Dharmintra
Healey, Andy
author_sort Relph, Sophie
collection PubMed
description OBJECTIVE: The aim of this review was to summarise the current evidence on the costing of resource use within UK maternity care, in order to facilitate the estimation of incremental resource and cost impacts potentially attributable to maternity care interventions. METHODS: A systematic review of economic evaluations was conducted by searching Medline, the Health Management Information Consortium, the National Health Service (NHS) Economic Evaluations Database, CINAHL and National Institute for Health and Care Excellence (NICE) guidelines for economic evaluations within UK maternity care, published between January 2010 and August 2019 in the English language. Unit costs for healthcare activities provided to women within the antenatal, intrapartum and postnatal period were inflated to 2018–2019 prices. Assessment of study quality was performed using the Quality of Health Economic Analyses checklist. RESULTS: Of 5084 titles or full texts screened, 37 papers were included in the final review (27 primary research articles, 7 review articles and 3 economic evaluations from NICE guidelines). Of the 27 primary research articles, 21 were scored as high quality, 3 as medium quality and 3 were low quality. Variation was noted in cost estimates for healthcare activities throughout the maternity care pathway: for midwife-led outpatient appointment, the range was £27.34–£146.25 (mean £81.78), emergency caesarean section, range was £1056.44–£4982.21 (mean £3508.93) and postnatal admission, range was £103.00–£870.10 per day (mean £469.55). CONCLUSIONS: Wide variation exists in costs applied to maternity healthcare activities, resulting in challenges in attributing cost to maternity activities. The level of variation in cost calculations is likely to reflect the uncertainty within the system and must be dealt with by conducting sensitivity analyses. Nationally agreed prices for granular unit costs are needed to standardise cost-effectiveness evaluations of new interventions within maternity care, to be used either for research purposes or decisions regarding national intervention uptake. PROSPERO REGISTRATION NUMBER: CRD42019145309.
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spelling pubmed-76048612020-11-12 Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations Relph, Sophie Delaney, Louisa Melaugh, Alexandra Vieira, Matias C Sandall, Jane Khalil, Asma Pasupathy, Dharmintra Healey, Andy BMJ Open Obstetrics and Gynaecology OBJECTIVE: The aim of this review was to summarise the current evidence on the costing of resource use within UK maternity care, in order to facilitate the estimation of incremental resource and cost impacts potentially attributable to maternity care interventions. METHODS: A systematic review of economic evaluations was conducted by searching Medline, the Health Management Information Consortium, the National Health Service (NHS) Economic Evaluations Database, CINAHL and National Institute for Health and Care Excellence (NICE) guidelines for economic evaluations within UK maternity care, published between January 2010 and August 2019 in the English language. Unit costs for healthcare activities provided to women within the antenatal, intrapartum and postnatal period were inflated to 2018–2019 prices. Assessment of study quality was performed using the Quality of Health Economic Analyses checklist. RESULTS: Of 5084 titles or full texts screened, 37 papers were included in the final review (27 primary research articles, 7 review articles and 3 economic evaluations from NICE guidelines). Of the 27 primary research articles, 21 were scored as high quality, 3 as medium quality and 3 were low quality. Variation was noted in cost estimates for healthcare activities throughout the maternity care pathway: for midwife-led outpatient appointment, the range was £27.34–£146.25 (mean £81.78), emergency caesarean section, range was £1056.44–£4982.21 (mean £3508.93) and postnatal admission, range was £103.00–£870.10 per day (mean £469.55). CONCLUSIONS: Wide variation exists in costs applied to maternity healthcare activities, resulting in challenges in attributing cost to maternity activities. The level of variation in cost calculations is likely to reflect the uncertainty within the system and must be dealt with by conducting sensitivity analyses. Nationally agreed prices for granular unit costs are needed to standardise cost-effectiveness evaluations of new interventions within maternity care, to be used either for research purposes or decisions regarding national intervention uptake. PROSPERO REGISTRATION NUMBER: CRD42019145309. BMJ Publishing Group 2020-10-30 /pmc/articles/PMC7604861/ /pubmed/33127635 http://dx.doi.org/10.1136/bmjopen-2020-040022 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Obstetrics and Gynaecology
Relph, Sophie
Delaney, Louisa
Melaugh, Alexandra
Vieira, Matias C
Sandall, Jane
Khalil, Asma
Pasupathy, Dharmintra
Healey, Andy
Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title_full Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title_fullStr Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title_full_unstemmed Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title_short Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations
title_sort costing the impact of interventions during pregnancy in the uk: a systematic review of economic evaluations
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604861/
https://www.ncbi.nlm.nih.gov/pubmed/33127635
http://dx.doi.org/10.1136/bmjopen-2020-040022
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