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A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies

OBJECTIVE: To determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies–Practical Obstetric Multi-Professional Training (PROMPT)–with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs). DESIGN: A model-based cost-...

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Autores principales: Yau, Christopher Wai Hung, Lenguerrand, Erik, Morris, Steve, Draycott, Tim, Pizzo, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987166/
https://www.ncbi.nlm.nih.gov/pubmed/33755716
http://dx.doi.org/10.1371/journal.pone.0249031
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author Yau, Christopher Wai Hung
Lenguerrand, Erik
Morris, Steve
Draycott, Tim
Pizzo, Elena
author_facet Yau, Christopher Wai Hung
Lenguerrand, Erik
Morris, Steve
Draycott, Tim
Pizzo, Elena
author_sort Yau, Christopher Wai Hung
collection PubMed
description OBJECTIVE: To determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies–Practical Obstetric Multi-Professional Training (PROMPT)–with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs). DESIGN: A model-based cost-utility analysis. SETTING: Maternity units in England. POPULATION: Simulated cohorts of individuals affected by permanent OBPIs. METHODS: A decision tree model was developed to estimate the cost-utility of adopting annual, PROMPT training (scenario 1a) or standalone shoulder dystocia training (scenario 1b) in all maternity units in England compared to current practice, where only a proportion of English units use the training programme (scenario 2). The time horizon was 30 years and the analysis was conducted from an English National Health Service (NHS) and Personal Social Services perspective. A probabilistic sensitivity analysis was performed to account for uncertainties in the model parameters. MAIN OUTCOME MEASURES: Outcomes for the entire simulated period included the following: total costs for PROMPT or shoulder dystocia training (including costs of OBPIs), number of OBPIs averted, number of affected adult/parental/dyadic quality adjusted life years (QALYs) gained and the incremental cost per QALY gained. RESULTS: Nationwide PROMPT or shoulder dystocia training conferred significant savings (in excess of £1 billion ($1.5 billion)) compared to current practice, resulting in cost-savings of at least £1 million ($1.5 million) per any type of QALY gained. The probabilistic sensitivity analysis demonstrated similar findings. CONCLUSION: In this model, national implementation of multi-professional simulation training for obstetric emergencies (or standalone shoulder dystocia training) in England appeared to both be cost-saving when evaluating their impact on permanent OBPIs.
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spelling pubmed-79871662021-04-02 A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies Yau, Christopher Wai Hung Lenguerrand, Erik Morris, Steve Draycott, Tim Pizzo, Elena PLoS One Research Article OBJECTIVE: To determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies–Practical Obstetric Multi-Professional Training (PROMPT)–with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs). DESIGN: A model-based cost-utility analysis. SETTING: Maternity units in England. POPULATION: Simulated cohorts of individuals affected by permanent OBPIs. METHODS: A decision tree model was developed to estimate the cost-utility of adopting annual, PROMPT training (scenario 1a) or standalone shoulder dystocia training (scenario 1b) in all maternity units in England compared to current practice, where only a proportion of English units use the training programme (scenario 2). The time horizon was 30 years and the analysis was conducted from an English National Health Service (NHS) and Personal Social Services perspective. A probabilistic sensitivity analysis was performed to account for uncertainties in the model parameters. MAIN OUTCOME MEASURES: Outcomes for the entire simulated period included the following: total costs for PROMPT or shoulder dystocia training (including costs of OBPIs), number of OBPIs averted, number of affected adult/parental/dyadic quality adjusted life years (QALYs) gained and the incremental cost per QALY gained. RESULTS: Nationwide PROMPT or shoulder dystocia training conferred significant savings (in excess of £1 billion ($1.5 billion)) compared to current practice, resulting in cost-savings of at least £1 million ($1.5 million) per any type of QALY gained. The probabilistic sensitivity analysis demonstrated similar findings. CONCLUSION: In this model, national implementation of multi-professional simulation training for obstetric emergencies (or standalone shoulder dystocia training) in England appeared to both be cost-saving when evaluating their impact on permanent OBPIs. Public Library of Science 2021-03-23 /pmc/articles/PMC7987166/ /pubmed/33755716 http://dx.doi.org/10.1371/journal.pone.0249031 Text en © 2021 Yau et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yau, Christopher Wai Hung
Lenguerrand, Erik
Morris, Steve
Draycott, Tim
Pizzo, Elena
A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title_full A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title_fullStr A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title_full_unstemmed A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title_short A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
title_sort model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987166/
https://www.ncbi.nlm.nih.gov/pubmed/33755716
http://dx.doi.org/10.1371/journal.pone.0249031
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