Levett Kate M, Dahlen Hannah G, Smith Caroline A, Finlayson Kenneth William, Downe Soo, Girosi Federico
School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia.
National Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, New South Wales, Australia.
BMJ Open. 2018 Feb 8;8(2):e017333. doi: 10.1136/bmjopen-2017-017333.
To assess whether the multitherapy antenatal education 'CTLB' (Complementary Therapies for Labour and Birth) Study programme leads to net cost savings.
Cost analysis of the CTLB Study, using analysis of outcomes and hospital funding data.
We take a payer perspective and use Australian Refined Diagnosis-Related Group (AR-DRG) cost data to estimate the potential savings per woman to the payer (government or private insurer). We consider scenarios in which the intervention cost is either borne by the woman or by the payer. Savings are computed as the difference in total cost between the control group and the study group.
If the cost of the intervention is not borne by the payer, the average saving to the payer was calculated to be $A808 per woman. If the payer covers the cost of the programme, this figure reduces to $A659 since the average cost of delivering the programme was $A149 per woman. All these findings are significant at the 95% confidence level. Significantly more women in the study group experienced a normal vaginal birth, and significantly fewer women in the study group experienced a caesarean section. The main cost saving resulted from the reduced rate of caesarean section in the study group.
The CTLB antenatal education programme leads to significant savings to payers that come from reduced use of hospital resources. Depending on which perspective is considered, and who is responsible for covering the cost of the programme, the net savings vary from $A659 to $A808 per woman. Compared with the average cost of birth in the control group, we conclude that the programme could lead to a reduction in birth-related healthcare costs of approximately 9%.
ACTRN12611001126909.
评估多模式产前教育“CTLB”（分娩与生产辅助疗法）研究项目是否能带来净成本节约。
对CTLB研究进行成本分析，采用结果分析和医院资金数据。
我们从支付方的角度出发，使用澳大利亚精细化诊断相关组（AR-DRG）成本数据来估计每位女性为支付方（政府或私人保险公司）带来的潜在节约。我们考虑了干预成本由女性承担或由支付方承担的情况。节约金额通过计算对照组和研究组之间的总成本差异得出。
如果干预成本不由支付方承担，计算得出支付方为每位女性的平均节约金额为808澳元。如果支付方承担该项目的成本，这一数字降至659澳元，因为该项目的人均成本为149澳元。所有这些结果在95%置信水平上具有统计学意义。研究组中顺产的女性显著更多，剖宫产的女性显著更少。主要的成本节约来自研究组剖宫产率的降低。
CTLB产前教育项目为支付方带来了显著的节约，这源于医院资源使用的减少。根据所考虑的角度以及谁负责承担项目成本，每位女性的净节约金额在659澳元至808澳元之间。与对照组的平均分娩成本相比，我们得出该项目可使与分娩相关的医疗保健成本降低约9%。
ACTRN12611001126909。
