The long-term cost-effectiveness of fetal monitoring during labour: a comparison of cardiotocography complemented with ST analysis versus cardiotocography alone.
BJOG
; 115(13): 1676-87, 2008 Dec.
Article
en En
| MEDLINE
| ID: mdl-19035942
ABSTRACT
OBJECTIVE:
To assess the cost-effectiveness of the use of cardiotocography (CTG) complemented with fetal electrocardiography and ST analysis compared with the use of CTG alone in term deliveries when a decision has been made to use fetal monitoring with a scalp electrode.DESIGN:
A cost-effectiveness analysis based on a probabilistic decision model incorporating relevant strategies and lifelong outcomes.SETTING:
Maternity wards in Sweden. POPULATION Women with term fetuses after a clinical decision had been made to apply a fetal scalp electrode for internal CTG.METHODS:
A decision model was used to compare the costs and effects of two different treatment strategies. Baseline estimates were derived from the literature. Discounted costs and quality-adjusted life years (QALYs) were simulated over a lifetime horizon using a probabilistic model. MAIN OUTCOMEMEASURES:
QALYs, incremental costs, and cost per QALY gained expressed as incremental cost-effectiveness ratio (ICER).RESULTS:
The analysis found an incremental effect of 0.005 QALYs for ST analysis compared with CTG; the ST analysis strategy was also moreover associated with a euro56 decrease in costs, thus dominating the CTG strategy. The probability that ST analysis is cost-effective in comparison with CTG is high, irrespective of the willingness-to-pay value for a QALY.CONCLUSIONS:
Compared with CTG alone, ST analysis is cost-effective when used in term high-risk deliveries in which there is a need for internal fetal monitoring.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cardiotocografía
/
Parálisis Cerebral
/
Hipoxia Fetal
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Female
/
Humans
Idioma:
En
Revista:
BJOG
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Suecia