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辅助生殖技术:澳大利亚公共资金与自愿向单胚胎移植的转变。

Assisted reproductive technology: public funding and the voluntary shift to single embryo transfer in Australia.

机构信息

Perinatal and Reproductive Epidemiology Research Unit, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.

出版信息

Med J Aust. 2011 Nov 21;195(10):594-8. doi: 10.5694/mja10.11448.

Abstract

OBJECTIVES

To calculate cost savings to the Australian federal and state governments from the reduction in twin and triplet birth rates for infants conceived by assisted reproductive technology (ART) since 2002, and to determine the number of ART treatment programs theoretically funded by means of these savings.

DESIGN AND SETTING

Costing model using data from the Australia and New Zealand Assisted Reproduction Database, the National Perinatal Data Collection and Medicare Australia on ART treatment cycles undertaken in Australia between 2002 and 2008.

MAIN OUTCOME MEASURES

Annual savings in maternal and infant inpatient birth-admission costs resulting from the reduction in ART multiple birth rate; theoretical number of ART treatment programs funded and infants born by means of these savings.

RESULTS

The reduction in the ART multiple birth rate from 18.8% in 2002 to 8.6% in 2008 resulted in estimated savings to government of $47.6 million in birth-admission costs alone. Theoretically, these savings funded 7042 ART treatment programs comprising one fresh plus one frozen embryo transfer cycle, equating to the birth of 2841 babies. Fifty-five per cent of the increased use of ART services since 2002 has been theoretically funded by the reduction in multiple birth infants.

CONCLUSIONS

Against a backdrop of supportive public funding of ART in Australia, a voluntary shift to single embryo transfer by fertility clinicians and ART patients has resulted in substantial savings in hospital costs. Much of the growth in ART use has been theoretically cross-subsidised by the move to safer embryo transfer practices.

摘要

目的

计算自 2002 年以来,通过辅助生殖技术(ART)受孕的双胞胎和三胞胎出生率下降为澳大利亚联邦和州政府节省的成本,并确定通过这些节省可以为多少个 ART 治疗项目提供理论资金。

设计和设置

使用澳大利亚和新西兰辅助生殖数据库、国家围产期数据收集和澳大利亚医疗保险中 2002 年至 2008 年期间在澳大利亚进行的 ART 治疗周期的数据,采用成本核算模型。

主要观察指标

由于 ART 多胎出生率下降,产妇和婴儿住院分娩入院费用的年度节省;通过这些节省可以为多少个 ART 治疗项目提供理论资金以及通过这些节省可以诞生多少婴儿。

结果

2002 年至 2008 年,ART 多胎出生率从 18.8%降至 8.6%,据估计仅在分娩入院费用方面就为政府节省了 4760 万美元。从理论上讲,这些节省资金可用于 7042 个 ART 治疗项目,其中包括一个新鲜胚胎加一个冷冻胚胎移植周期,相当于 2841 个婴儿的诞生。自 2002 年以来,ART 服务的使用量增加了 55%,这在理论上是通过减少多胎婴儿来提供资金的。

结论

在澳大利亚支持性公共 ART 资金的背景下,生育临床医生和 ART 患者自愿转向单胚胎移植,导致医院成本大幅节省。ART 使用量的增长大部分是通过转向更安全的胚胎转移实践来实现的理论交叉补贴。

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