Fox Aimée, McHugh Sheena, Browne John, Kenny Louise C, Fitzgerald Anthony, Khashan Ali S, Dempsey Eugene, Fahy Ciara, O'Neill Ciaran, Kearney Patricia M
From the Department of Epidemiology and Public Health (A.F., S.M., J.B., A.F., A.S.K., C.F., P.M.K.), Irish Centre for Fetal and Neonatal Translational Research (INFANT) (L.C.K., A.S.K., E.D.), Department of Obstetrics and Gynaecology (L.C.K.), and Department of Paediatrics and Child Health (E.D.), University College Cork, Ireland; and Centre for Public Health, Queens University, Belfast, Northern Ireland, United Kingdom (C.O.).
Hypertension. 2017 Dec;70(6):1243-1249. doi: 10.1161/HYPERTENSIONAHA.117.09499. Epub 2017 Oct 30.
To estimate the cost of preeclampsia from the national health payer's perspective using secondary data from the SCOPE study (Screening for Pregnancy End Points). SCOPE is an international observational prospective study of healthy nulliparous women with singleton pregnancies. Using data from the Irish cohort recruited between November 2008 and February 2011, all women with preeclampsia and a 10% random sample of women without preeclampsia were selected. Additional health service use data were extracted from the consenting participants' medical records for maternity services which were not included in SCOPE. Unit costs were based on estimates from 3 existing Irish studies. Costs were extrapolated to a national level using a prevalence rate of 5% to 7% among nulliparous pregnancies. Within the cohort of 1774 women, 68 developed preeclampsia (3.8%) and 171 women were randomly selected as controls. Women with preeclampsia used higher levels of maternity services. The average cost of a pregnancy complicated by preeclampsia was €5243 per case compared with €2452 per case for an uncomplicated pregnancy. The national cost of preeclampsia is between €6.5 and €9.1 million per annum based on the 5% to 7% prevalence rate. Postpartum care was the largest contributor to these costs (€4.9-€6.9 million), followed by antepartum care (€0.9-€1.3 million) and peripartum care (€0.6-€0.7 million). Women with preeclampsia generate significantly higher maternity costs than women without preeclampsia. These cost estimates will allow policy-makers to efficiently allocate resources for this pregnancy-specific condition. Moreover, these estimates are useful for future research assessing the cost-effectiveness of preeclampsia screening and treatment.
从国家医疗支付方的角度,利用“妊娠结局筛查”(SCOPE)研究的二手数据估算子痫前期的成本。SCOPE是一项针对单胎妊娠健康未生育女性的国际观察性前瞻性研究。利用2008年11月至2011年2月招募的爱尔兰队列数据,选取了所有子痫前期女性以及10%未患子痫前期女性的随机样本。从同意参与研究的产妇医疗记录中提取了SCOPE未涵盖的其他医疗服务使用数据。单位成本基于爱尔兰3项现有研究的估算。使用未生育妊娠中5%至7%的患病率将成本推算至全国水平。在1774名女性队列中,68人患子痫前期(3.8%),随机选取171名女性作为对照。子痫前期女性使用的产妇服务水平更高。子痫前期妊娠的平均成本为每例5243欧元,而未并发子痫前期妊娠的平均成本为每例2452欧元。基于5%至7%的患病率,子痫前期的全国成本每年在650万至910万欧元之间。产后护理是这些成本的最大贡献部分(490万至690万欧元),其次是产前护理(90万至130万欧元)和围产期护理(60万至70万欧元)。子痫前期女性产生的产妇成本显著高于未患子痫前期的女性。这些成本估算将使政策制定者能够有效地为这种特定于妊娠的病症分配资源。此外,这些估算对于未来评估子痫前期筛查和治疗成本效益的研究很有用。