Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit
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Christopher R.H. White
,
Dorota A. Doherty
Abstract
Objective: There is an increasing body of literature supporting universal umbilical cord blood gas analysis (UCBGA) into all maternity units. A significant impediment to UCBGA’s introduction is the perceived expense of the introduction and associated ongoing costs. Consequently, this study set out to conduct the first cost-effectiveness analysis of introducing universal UCBGA.
Methods: Analysis was based on 42,100 consecutive deliveries ≥23 weeks of gestation at a single tertiary obstetric unit. Within 4 years of UCBGA’s introduction there was a 45% reduction in term special care nursery (SCN) admissions >2499 g. Incurred costs included initial and ongoing costs associated with universal UCBGA. Averted costs were based on local diagnosis-related grouping costs for reduction in term SCN admissions. Incremental cost-effectiveness ratio (ICER) and sensitivity analysis results were reported.
Results: Under the base-case scenario, the adoption of universal UCBGA was less costly and more effective than selective UCBGA over 4 years and resulted in saving of AU$641,532 while adverting 376 SCN admissions. Sensitivity analysis showed that UCBGA was cost-effective in 51.8%, 83.3%, 99.6% and 100% of simulations in years 1, 2, 3 and 4. These conclusions were not sensitive to wide, clinically possible variations in parameter values for neonatal intensive care unit and SCN admissions, magnitude of averted SCN admissions, cumulative delivery numbers, and SCN admission costs.
Conclusions: Universal UCBGA is associated with significant initial and ongoing costs; however, potential averted costs (due to reduced SCN admissions) exceed incurred costs in most scenarios.
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©2016 by De Gruyter
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Articles in the same Issue
- Frontmatter
- Editorial
- Preventing preterm birth
- Original articles
- Vertically transmitted cytomegalovirus infection in newborn preterm infants
- Computerized vital signs analysis and late onset infections in extremely low gestational age infants
- Oral propranolol in early stages of retinopathy of prematurity
- Changes in incidence of iatrogenic and spontaneous preterm births over time: a population-based study
- Predictive factors for preterm delivery under rural conditions in post-tsunami Banda Aceh
- Early pregnancy serum neopterin concentrations predict spontaneous preterm birth in asymptomatic pregnant women
- Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes
- Amniotic fluid LPCAT1 mRNA correlates with the lamellar body count
- Recommendation and Guidelines for Perinatal Practice
- Fetal magnetic resonance imaging and ultrasound
- Original articles - Obstetrics
- Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome
- Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage
- Extra-abdominal removal of placenta during cesarean section: a prospective randomized controlled trial of a novel technique
- Correlation of intrapartum translabial ultrasound parameters with computed tomographic 3D reconstruction of the female pelvis
- Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit
- Original articles - Fetus
- Is there a sex difference in fetal behavior? A comparison of the KANET test between male and female fetuses
- Determination of antepartum and intrapartum risk factors associated with neonatal intensive care unit admission
- Short communication
- A guide on how to build a novel home-made part task training simulator for cervical cerclage training
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