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Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study

BACKGROUND: Preterm birth is associated with adverse health and developmental sequelae that impose a burden on finite resources and significant challenges for individuals, families and societies. OBJECTIVES: To estimate economic outcomes at age 11 associated with extremely preterm birth using eviden...

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Detalles Bibliográficos
Autores principales: Achana, Felix, Johnson, Samantha, Ni, Yanyan, Marlow, Neil, Wolke, Dieter, Khan, Kamran, Petrou, Stavros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543967/
https://www.ncbi.nlm.nih.gov/pubmed/35830294
http://dx.doi.org/10.1111/ppe.12906
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author Achana, Felix
Johnson, Samantha
Ni, Yanyan
Marlow, Neil
Wolke, Dieter
Khan, Kamran
Petrou, Stavros
author_facet Achana, Felix
Johnson, Samantha
Ni, Yanyan
Marlow, Neil
Wolke, Dieter
Khan, Kamran
Petrou, Stavros
author_sort Achana, Felix
collection PubMed
description BACKGROUND: Preterm birth is associated with adverse health and developmental sequelae that impose a burden on finite resources and significant challenges for individuals, families and societies. OBJECTIVES: To estimate economic outcomes at age 11 associated with extremely preterm birth using evidence from a whole population study (EPICure2 study). METHODS: The study population comprised a sample of children born at ≤26 completed weeks of gestation during 2006 in England (n = 200) and a comparison group of classmates born at term (n = 143). Societal costs were estimated using parent and teacher reports of service utilisation, and valuations of work losses and additional care costs to families. Utility scores for the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) were generated using UK and Canadian value sets. Generalised linear regression was used to estimate the impact of extremely preterm birth on societal costs and utility scores. RESULTS: Unadjusted mean societal costs that excluded provision of special educational support in mainstream schools during the 11th year after birth were £6536 for the extremely preterm group and £3275 for their classmates, generating a difference of £3262 (95% confidence interval [CI] £1912, £5543). The mean adjusted cost difference was £2916 (95% CI £1609, £4224), including special educational needs provision in mainstream schools increased the adjusted cost difference to £4772 (95% CI £3166, £6378). Compared with birth at term, extremely preterm birth generated mean‐adjusted utility decrements ranging from 0.13 (95% CI 0.09, 0.18) based on the UK HUI2 statistical inference tariff to 0.28 (95% CI 0.18, 0.37) based on the Canadian HUI3 tariff. CONCLUSIONS: The adverse economic impact of extremely preterm birth persists into late childhood. Further longitudinal studies conducted from multiple perspectives are needed to understand the magnitude, trajectory and underpinning mechanisms of economic outcomes following extremely preterm birth.
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spelling pubmed-95439672022-10-14 Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study Achana, Felix Johnson, Samantha Ni, Yanyan Marlow, Neil Wolke, Dieter Khan, Kamran Petrou, Stavros Paediatr Perinat Epidemiol Special Issue Articles BACKGROUND: Preterm birth is associated with adverse health and developmental sequelae that impose a burden on finite resources and significant challenges for individuals, families and societies. OBJECTIVES: To estimate economic outcomes at age 11 associated with extremely preterm birth using evidence from a whole population study (EPICure2 study). METHODS: The study population comprised a sample of children born at ≤26 completed weeks of gestation during 2006 in England (n = 200) and a comparison group of classmates born at term (n = 143). Societal costs were estimated using parent and teacher reports of service utilisation, and valuations of work losses and additional care costs to families. Utility scores for the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) were generated using UK and Canadian value sets. Generalised linear regression was used to estimate the impact of extremely preterm birth on societal costs and utility scores. RESULTS: Unadjusted mean societal costs that excluded provision of special educational support in mainstream schools during the 11th year after birth were £6536 for the extremely preterm group and £3275 for their classmates, generating a difference of £3262 (95% confidence interval [CI] £1912, £5543). The mean adjusted cost difference was £2916 (95% CI £1609, £4224), including special educational needs provision in mainstream schools increased the adjusted cost difference to £4772 (95% CI £3166, £6378). Compared with birth at term, extremely preterm birth generated mean‐adjusted utility decrements ranging from 0.13 (95% CI 0.09, 0.18) based on the UK HUI2 statistical inference tariff to 0.28 (95% CI 0.18, 0.37) based on the Canadian HUI3 tariff. CONCLUSIONS: The adverse economic impact of extremely preterm birth persists into late childhood. Further longitudinal studies conducted from multiple perspectives are needed to understand the magnitude, trajectory and underpinning mechanisms of economic outcomes following extremely preterm birth. John Wiley and Sons Inc. 2022-07-13 2022-09 /pmc/articles/PMC9543967/ /pubmed/35830294 http://dx.doi.org/10.1111/ppe.12906 Text en © 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Special Issue Articles
Achana, Felix
Johnson, Samantha
Ni, Yanyan
Marlow, Neil
Wolke, Dieter
Khan, Kamran
Petrou, Stavros
Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title_full Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title_fullStr Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title_full_unstemmed Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title_short Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study
title_sort economic costs and health utility values associated with extremely preterm birth: evidence from the epicure2 cohort study
topic Special Issue Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543967/
https://www.ncbi.nlm.nih.gov/pubmed/35830294
http://dx.doi.org/10.1111/ppe.12906
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