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即刻流产后放置宫内节育器与流产后随访时计划放置宫内节育器的成本分析。

Cost analysis of immediate postabortal IUD insertion compared to planned IUD insertion at the time of abortion follow up.

机构信息

Department of Obstetrics & Gynecology, University of California, Los Angeles, Los Angeles, CA 90095, USA.

出版信息

Contraception. 2013 Apr;87(4):404-8. doi: 10.1016/j.contraception.2012.11.011. Epub 2013 Jan 8.

Abstract

BACKGROUND

Immediate postabortal intrauterine device (IUD) insertion decreases rates of repeat abortions. However, only one third of high-volume, non-hospital abortion providers in the United States offer immediate postabortal IUD placement.

STUDY DESIGN

We conducted a cost analysis from a public payer perspective to evaluate the potential cost savings associated with a policy of immediate postabortal IUD insertion, compared to planned IUD insertion at the time of abortion follow up. Sensitivity analyses and Monte Carlo simulation were performed.

RESULTS

Considering only direct costs of contraception and pregnancy-related care over 1 year, immediate postabortal IUD provision decreases public program expenditures by US$111 per woman compared to planned IUD placement at follow up. Over 5 years, the savings increases to $4296 per woman, when public health and social program costs are also considered.

CONCLUSION

Immediate postabortal IUD insertion is cost saving from a public payer perspective, compared to planned insertion at the time of follow up. These savings are seen over a wide range of model inputs.

摘要

背景

即时流产后宫内节育器(IUD)放置可降低重复流产率。然而,在美国,只有三分之一的大容量非医院堕胎服务提供者提供即时流产后 IUD 放置。

研究设计

我们从公共支付者的角度进行了成本分析,以评估与流产后随访时计划 IUD 放置相比,即时流产后 IUD 放置相关的潜在成本节约。进行了敏感性分析和蒙特卡罗模拟。

结果

仅考虑 1 年内避孕和与妊娠相关护理的直接成本,即时流产后 IUD 放置与随访时计划 IUD 放置相比,每位女性可减少公共计划支出 111 美元。如果还考虑公共卫生和社会计划成本,则在 5 年内,每位女性的节省额增加到 4296 美元。

结论

与随访时计划放置相比,即时流产后 IUD 放置从公共支付者的角度来看具有成本效益。这些节省在模型输入的广泛范围内可见。

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