Value Evidence & Outcomes, GlaxoSmithKline, 1250 South Collegeville Road, Upper Providence, PA, 19426, USA.
Real World Evidence and Epidemiology, GlaxoSmithKline, London, UK.
BMC Pregnancy Childbirth. 2018 Jul 4;18(1):284. doi: 10.1186/s12884-018-1912-0.
Preterm labour and birth (PTL/PTB) is characterised by major health and developmental risks for children, life-changing consequences for their families, and substantial healthcare and economic challenges for wider society. While it is known that PTL/PTB impacts infant healthcare costs in the short and long term in Germany, maternal costs have not been described in detail. The aim of this study was to comprehensively describe costs and resource use among PTL/PTB mothers during pregnancy, at hospitalisation for delivery, and up to three years after delivery-overall and according to gestational age (GA) at delivery.
This study used data from the Statutory Health Insurance (SHI) sample of the AOK Hessen database in Germany. Mothers aged 12-44 years with deliveries between 2009 and 2013 and > 9 months of medical history prior to delivery were included. PTL/PTB mothers were defined by an International Classification of Diseases, 10th Revision (ICD-10) code for PTL during pregnancy, a diagnosis-related group (DRG) code indicating birthweight < 2500 g, or delivery of an infant < 37 weeks GA. Inpatient and outpatient resource use and total direct medical costs were examined during pregnancy, at delivery hospitalisation, and up to three years post-delivery.
Of all mothers, 2147 (20%) experienced PTL/PTB. During pregnancy, median costs for PTL/PTB mothers were €2130. During delivery hospitalisation, the mean length of stay for all PTL/PTB mothers was 6.0 days, and median costs were €2037. Length of stay and costs declined with increasing GA. Long term, PTL/PTB mothers' total median costs were €607 in Year 1, €332 in Year 2, and €388 in Year 3 post-delivery. In each year after delivery, median costs appeared to be greater for mothers who delivered at lower GAs.
In this description of costs and resource use among PTL/PTB mothers in Germany throughout the pregnancy and up to three years after delivery, the greatest costs were noted prior to delivery. Costs appeared to decrease with increasing GA, particularly during the delivery hospitalisation and the first year after delivery.
早产和分娩（PTL/PTB）的特点是对儿童的重大健康和发育风险、对其家庭的改变生活的后果，以及对更广泛的社会的大量医疗保健和经济挑战。虽然已知 PTL/PTB 会影响德国婴儿的短期和长期医疗保健成本，但尚未详细描述产妇成本。本研究的目的是全面描述 PTL/PTB 母亲在怀孕期间、分娩时住院期间以及分娩后三年期间的成本和资源利用情况——总体情况以及根据分娩时的胎龄（GA）情况。
本研究使用了德国 AOK Hessen 数据库的法定健康保险（SHI）样本中的数据。纳入了年龄在 12-44 岁之间、2009 年至 2013 年分娩且分娩前有>9 个月病史的母亲。PTL/PTB 母亲的定义是妊娠期间有国际疾病分类，第 10 版（ICD-10）PTL 编码、诊断相关组（DRG）编码表明出生体重<2500 克或分娩婴儿<37 周 GA。检查了怀孕期间、分娩时住院期间以及分娩后三年期间的住院和门诊资源利用情况和总直接医疗费用。
所有母亲中，有 2147 人（20%）经历了 PTL/PTB。怀孕期间，PTL/PTB 母亲的中位费用为 2130 欧元。在分娩住院期间，所有 PTL/PTB 母亲的平均住院时间为 6.0 天，中位费用为 2037 欧元。随着 GA 的增加，住院时间和费用减少。长期来看，PTL/PTB 母亲在分娩后第一年的总中位费用为 607 欧元，第二年为 332 欧元，第三年为 388 欧元。在分娩后每年，GA 较低的母亲的中位费用似乎更高。
在本研究中，描述了德国 PTL/PTB 母亲在整个孕期和分娩后三年期间的成本和资源利用情况，分娩前的成本最高。随着 GA 的增加，成本似乎有所下降，尤其是在分娩住院期间和分娩后第一年。
