Mvundura Mercy, Kokonya Donald, Abu-Haydar Elizabeth, Okoth Eunice, Herrick Tara, Mukabi James, Carlson Lucas, Oguttu Monica, Burke Thomas
Devices and Tools Global Program, PATH, Seattle, WA, USA.
School of Medicine, Masinde Muliro University of Science and Technology, Kakamega, Kenya.
Int J Gynaecol Obstet. 2017 May;137(2):185-191. doi: 10.1002/ijgo.12125. Epub 2017 Mar 7.
To evaluate the cost-effectiveness of condom uterine balloon tamponade (UBT) for control of severe postpartum hemorrhage (PPH) due to uterine atony versus standard PPH care in Kenya.
A cross-sectional analysis was conducted using cost data collected from 30 facilities in Western Kenya from April 15 to July 16, 2015. Effectiveness data were derived from the published literature. The modeling analysis was performed from the health-system perspective for a cohort of women who gave birth in 2015. Sensitivity analyses tested the robustness of model estimates. Costs were in 2015 US dollars.
Compared with standard care with no uterine packing, condom UBT could prevent 1255 hospital transfers, 430 hysterectomies, and 44 maternal deaths. At $5 or $15 per UBT device, the incremental cost per disability-adjusted life year (DALY) averted was $26 or $40, respectively. If uterine packing was assumed to be done with standard care, the cost per DALY averted was $164 when the UBT price was $5 and $199 when the price was $15.
Condom UBT was a highly cost-effective intervention for controlling severe PPH. This finding remained robust even when key model inputs were varied by wide margins.
评估在肯尼亚，使用避孕套子宫球囊填塞术（UBT）控制因子宫收缩乏力引起的严重产后出血（PPH）相对于标准PPH护理的成本效益。
采用横断面分析，使用2015年4月15日至7月16日从肯尼亚西部30家医疗机构收集的成本数据。有效性数据来自已发表的文献。从卫生系统角度对2015年分娩的一组妇女进行建模分析。敏感性分析测试了模型估计的稳健性。成本以2015年美元计算。
与不进行子宫填塞的标准护理相比，避孕套UBT可预防1255例住院转诊、430例子宫切除术和44例孕产妇死亡。每例UBT装置价格为5美元或15美元时，每避免一个伤残调整生命年（DALY）的增量成本分别为26美元或40美元。如果假设标准护理进行子宫填塞，当UBT价格为5美元时，每避免一个DALY的成本为164美元，当价格为15美元时为199美元。
避孕套UBT是控制严重PPH的一种高成本效益的干预措施。即使关键模型输入有很大变化，这一发现仍然稳健。
