Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095, USA; California Center for Population Research, UCLA, Los Angeles, CA, USA.
California Center for Population Research, UCLA, Los Angeles, CA, USA; Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA.
Prev Med. 2019 Jul;124:42-49. doi: 10.1016/j.ypmed.2019.04.011. Epub 2019 Apr 16.
There is growing evidence that prenatal participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) reduces the risk of adverse birth outcomes. With recent changes in health care, rising health care costs, and increasing rates of prematurity in the U.S., there is urgency to estimate the potential cost savings associated with prenatal WIC participation. A cost-benefit analysis from a societal perspective with a time horizon over the newborn's life course for a hypothetical cohort of 500,000 Californian pregnant women was conducted in 2017. A universal coverage, a status quo ('business as usual') and a reference scenario (absence of WIC) were compared. Total societal costs, incremental cost savings, return on investment, number of preterm births prevented, and incremental net monetary benefits were reported. WIC resulted in cost-savings of about $349 million and the prevention of 7575 preterm births and would save more if it were universal. Spending $1 on prenatal WIC resulted in mean savings of $2.48 (range: $1.24 to $6.83). Decreasing prenatal WIC enrollment by 10% would incur additional costs (i.e. loss) of about $45.3 million to treat the resulting 981 preterm babies. In contrast, a 10% increase in prenatal WIC enrollment would prevent 141 preterm births and achieve additional cost-savings of $6.5 million. The findings confirm evaluations from the early 1990s that prenatal WIC participation is cost-saving and cost-effective. Further savings could be achieved if all eligible women were enrolled in WIC. Substantial preterm birth-related costs would result from reductions in WIC participation.
越来越多的证据表明，妇女、婴儿和儿童特别补充营养计划（WIC）产前参与可降低不良出生结局的风险。随着最近医疗保健的变化、医疗保健成本的上升以及美国早产儿率的上升，迫切需要估计与产前 WIC 参与相关的潜在成本节约。2017 年，从社会角度对一个假设的 50 万加州孕妇队列进行了成本效益分析，时间范围跨越新生儿的整个生命周期。对普遍覆盖、现状（按常规进行）和参考方案（没有 WIC）进行了比较。报告了总社会成本、增量成本节约、投资回报率、预防的早产数量和增量净货币收益。WIC 可节省约 3.49 亿美元，预防 7575 例早产，如果普遍实施，还可以节省更多。产前 WIC 每花费 1 美元，平均可节省 2.48 美元（范围：1.24 美元至 6.83 美元）。如果将产前 WIC 的参与率降低 10%，将导致约 4530 万美元的额外成本（即损失）来治疗由此产生的 981 名早产儿。相比之下，产前 WIC 参与率增加 10%可预防 141 例早产，并实现额外的 650 万美元成本节约。研究结果证实了 20 世纪 90 年代早期的评估，即产前 WIC 参与是节省成本和具有成本效益的。如果所有符合条件的妇女都参加 WIC，还可以节省更多成本。如果 WIC 参与减少，将会产生大量与早产相关的成本。
