Day care versus inpatient management of nausea and vomiting of pregnancy: cost utility analysis of a randomised controlled trial.
Eur J Obstet Gynecol Reprod Biol
; 197: 78-82, 2016 Feb.
Article
en En
| MEDLINE
| ID: mdl-26708475
ABSTRACT
OBJECTIVE:
To assess the comparative cost effectiveness of day care over inpatient management of nausea and vomiting of pregnancy (NVP). STUDYDESIGN:
A cost utility analysis was performed using a decision analytical model in which a Markov model was constructed. The Markov model was primarily populated with data from a recently published randomised controlled trial. Which included pregnant women presenting to Cork University Maternity Hospital, a tertiary referral maternity hospital, seeking treatment for NVP. Costs and outcomes were estimated from the perspective of the Irish health service (HSE) and patients. A probabilistic sensitivity analysis, using a Monte Carlo simulation, was also performed. A Bayesian Value of Information analysis was used to estimate the value of collecting additional information.RESULTS:
When both the healthcare provider and patient's perspective was considered, day care management of NVP remained less costly (mean 985; 95% C.I. 705-1456 vs. 3837 (2124-8466)) and more effective (9.42; 4.19-12.25 vs. 9.49; 4.32-12.39 quality adjusted life years) compared with inpatient management. The Cost Effectiveness Acceptability Curve indicates the probability that day care management is 70% more cost effective compared to inpatient management at a ceiling ratio of 45,000 per QALY, indicating little decision uncertainty. The Bayesian Value of Information analysis indicates there is value in collecting further information; the Expected Value of Perfect Information (EVPI) is estimated to be 5.4 million.CONCLUSION:
Day care management of NVP is cost effective compared to inpatient management.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Años de Vida Ajustados por Calidad de Vida
/
Centros de Día
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Atención Ambulatoria
/
Hospitalización
/
Hiperemesis Gravídica
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Adult
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Female
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Humans
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Obstet Gynecol Reprod Biol
Año:
2016
Tipo del documento:
Article