Barghazan Saeed Husseini, Hadian Mohamad, Rezapour Aziz, Nassiri Setare
Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Educ Health Promot. 2022 Jun 30;11:184. doi: 10.4103/jehp.jehp_1274_21. eCollection 2022.
Pregnancy termination and abortion-related complications are well-established problems among women at reproductive age and resulted in significant morbidity and mortality. Accordingly, a systematic study was performed to investigate the economic evaluation studies results on costs and benefits of medical and surgical abortion methods. PubMed, Web of Science, Scopus, Embase, Cochrane library, ProQuest, and ScienceDirect databases as well as Google scholar were searched through June 2021. Original full-text English language studies that performed an economic evaluation analysis comparing medical and surgical methods of pregnancy termination were included in this review. A critical quality assessment was conducted utilizing the Consolidated Health Economic Evaluation Standards checklist. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2020 $US). Overall, 538 records were retrieved, and 20 studies were deemed eligible for qualitative synthesis. Among the reviewed studies, three studies investigated cost-minimization analysis, three studies investigated cost-utility analysis, and 14 studies investigated cost-effectiveness analysis. The directly comparison of medical with surgical abortion was most frequently studied. Medical abortion saved US$ 6 to US$ 2373 per patient's costs. Medical abortion was cost-effective and cost-saving option in compare to the surgical abortion across all perspectives (the incremental cost effectiveness ratio ranged from US$ 419 to US$ 4,044). Quality scores of included studies ranged from 54% to 100%, and 70% of studies received a score of above 85% and had "excellent" quality. According to the results, based on various economic and clinical effectiveness decision-making criteria used in different studies of health economic evaluation, the majority of research provided evidence on the advantage of pharmaceutical methods compared to surgical methods, as well as the advantages of using combinations therapy compared to single therapeutic interventions.
终止妊娠及与流产相关的并发症是育龄女性中公认的问题，会导致严重的发病和死亡情况。因此，开展了一项系统研究，以调查关于药物流产和手术流产方法成本与效益的经济评估研究结果。检索了截至2021年6月的PubMed、科学网、Scopus、Embase、Cochrane图书馆、ProQuest和ScienceDirect数据库以及谷歌学术。本综述纳入了进行经济评估分析以比较药物流产和手术流产方法的英文原文全文研究。利用《综合卫生经济评估标准》清单进行了严格的质量评估。最新的基于网络的工具将以一种特定货币和价格年份表示的成本估算调整为特定目标货币（2020年美元）。总体而言，检索到538条记录，20项研究被认为符合定性综合分析的条件。在纳入综述的研究中，3项研究调查了成本最小化分析，3项研究调查了成本效用分析，14项研究调查了成本效益分析。药物流产与手术流产的直接比较是研究最频繁的。药物流产每位患者的成本节省了6美元至2373美元。从所有角度来看，与手术流产相比，药物流产是具有成本效益且节省成本的选择（增量成本效益比在419美元至4044美元之间）。纳入研究的质量得分在54%至100%之间，70%的研究得分高于85%，质量为“优秀”。根据研究结果，基于不同卫生经济评估研究中使用的各种经济和临床有效性决策标准，大多数研究提供了证据，表明药物方法相对于手术方法的优势，以及联合治疗相对于单一治疗干预的优势。
