Lanssens Dorien, Vonck Sharona, Vandenberk Thijs, Schraepen Cédric, Storms Valerie, Thijs Inge M, Grieten Lars, Gyselaers Wilfried
1Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
2Department of Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
Telemed J E Health. 2019 Aug;25(8):686-692. doi: 10.1089/tmj.2018.0147. Epub 2018 Oct 30.
Background:In 2015, we performed a cost analysis of a prenatal remote monitoring (RM) program compared with conventional care (CC) for women diagnosed with gestational hypertensive disorders (GHD).
Introduction:We investigated where the cost savings were distributed by dividing our patient population into three subgroups, according to the gestational age (GA) at the time of delivery: (1) <34 weeks; (2) 34-37 weeks; and (3) >37 weeks of GA.
Materials and Methods:Health care costs were calculated from patient-specific hospital bills at Ziekenhuis Oost Limburg (Genk, Belgium) in 2015-2016. Cost comparisons were made from the perspectives of the Belgium national health care system (HCS), the National Institution for Insurance of Disease and Disability (RIZIV), and the costs to individual patients.
Results:A total of 256 pregnant women were included, 80 (31.25%) of whom received RM and 176 (68.75%) of whom received CC. The greatest difference in costs between RM and CC was in the group that delivered before 34 weeks of GA, followed by the group who delivered after 37 weeks of GA, and then the group of women who delivered at 34-37 weeks of GA. Most of the cost savings were in neonatal care, for both the three separate study subgroups and the total study group.
Discussion and Conclusion:Our data showed that RM is more cost-effective than CC for pregnant women with GHD. Further investigation of the effects of RM on the long-term economic and social costs is recommended, together with an analysis of the price that should be asked for RM services.
2015年,我们对一项产前远程监测(RM)项目与针对诊断为妊娠期高血压疾病(GHD)的女性的常规护理(CC)进行了成本分析。
我们根据分娩时的孕周(GA)将患者人群分为三个亚组,以研究成本节省分布在哪些方面:(1)<34周;(2)34 - 37周;(3)GA>37周。
医疗保健成本根据2015 - 2016年比利时东林堡医院(根克,比利时)患者的特定医院账单计算得出。从比利时国家医疗保健系统(HCS)、国家疾病与残疾保险机构(RIZIV)以及个体患者成本的角度进行了成本比较。
共纳入256名孕妇,其中80名(31.25%)接受RM,176名(68.75%)接受CC。RM与CC之间成本差异最大的是GA在34周之前分娩的组,其次是GA在37周之后分娩的组,然后是GA在34 - 37周分娩的女性组。对于三个单独的研究亚组以及整个研究组而言,大部分成本节省都在新生儿护理方面。
我们的数据表明,对于患有GHD的孕妇,RM比CC更具成本效益。建议进一步研究RM对长期经济和社会成本的影响,并分析RM服务应收取的价格。