Wu Jinjing, Dean Kelsey S, Rosen Zohn, Muennig Peter A
J Health Care Poor Underserved. 2017;28(4):1578-1597. doi: 10.1353/hpu.2017.0134.
We evaluated whether Nurse-Family Partnership might serve as a cost-effective social policy for improving health. Using data from studies of randomized controlled trials as well as real-world data, we conducted a Monte Carlo simulation to estimate cost-effectiveness of Nurse-Family Partnership in a hypothetical cohort of first-born children in the United States. Analyses were conducted in 2015. Were all new mothers eligible for Nurse-Family Partnership, the program would produce 0.11 QALYs (95% confidence interval [CI]=0.06, 0.17) at an additional cost of $1,021 (95% CI=-$2,831, $4,414) per nurse-visited child's lifetime relative to the comparison-group children or $14,642 (95% CI = Savings, $71,877) per QALY gained. However, if applied to high-risk mothers, it would generate 0.19 QALYs (95% CI = 0.09, 0.44) and a net benefit of $2,764 (95% CI =-$1,210, $7,092) per nurse-visited child. Nurse-Family Partnership should be considered as a policy investment, particularly in an era of investments in the social determinants of health.
我们评估了“护士-家庭伙伴关系”项目是否可能成为一项具有成本效益的改善健康的社会政策。利用随机对照试验研究数据以及实际数据,我们进行了蒙特卡洛模拟,以估计“护士-家庭伙伴关系”项目在美国一个假设的头胎儿童队列中的成本效益。分析于2015年进行。如果所有新妈妈都有资格参加“护士-家庭伙伴关系”项目,相对于对照组儿童,该项目在每个接受护士家访的儿童一生中将额外产生0.11个质量调整生命年(95%置信区间[CI]=0.06,0.17),额外成本为1021美元(95%CI=-2831美元,4414美元),或每获得一个质量调整生命年产生14642美元(95%CI=节省成本,71877美元)。然而,如果应用于高危母亲,每个接受护士家访的儿童将产生0.19个质量调整生命年(95%CI=0.09,0.44),净效益为2764美元(95%CI=-1210美元,7092美元)。“护士-家庭伙伴关系”项目应被视为一项政策投资,尤其是在一个对健康的社会决定因素进行投资的时代。