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dc.contributor.authorCallander, Emily J
dc.contributor.authorCreedy, Debra K
dc.contributor.authorGamble, Jenny
dc.contributor.authorFox, Haylee
dc.contributor.authorToohill, Jocelyn
dc.contributor.authorSneddon, Anne
dc.contributor.authorEllwood, David
dc.date.accessioned2020-01-12T22:54:21Z
dc.date.available2020-01-12T22:54:21Z
dc.date.issued2019
dc.identifier.issn0269-5022
dc.identifier.doi10.1111/ppe.12621
dc.identifier.urihttp://hdl.handle.net/10072/390114
dc.description.abstractBackground: Clinical interventions known to reduce the risk of caesarean delivery include routine induction of labour at 39 weeks, caseload midwifery and chart audit, but they have not been compared for cost-effectiveness. Objective: To assesses the cost-effectiveness of three different interventions known to reduce caesarean delivery rates compared to standard care; and conduct a budget impact analysis. Methods: A Markov microsimulation model was constructed to compare the costs and outcomes produced by the different interventions. Costs included all costs to the health system, and outcomes were quality-adjusted life years (QALY) gained. A budget impact analysis was undertaken using this model to quantify the costs (in Australian dollars) over three years for government health system funders. Results: All interventions, plus standard care, produced similar health outcomes (mean of 1.84 QALYs gained over 105 weeks). Caseload midwifery was the lowest cost option at $15 587 (95% confidence interval [CI] 15 269, 15 905), followed by routine induction of labour ($16 257, 95% CI 15 989, 16 536), and chart audit ($16 325, 95% CI 15 979, 16 671). All produced lower costs on average than standard care ($16 905, 95% CI 16 551, 17 259). Caseload midwifery would produce the greatest savings of $172.6 million over three years if implemented for all low-risk nulliparous women in Australia. Conclusions: Caseload midwifery presents the best value for reducing caesarean delivery rates of the options considered. Routine induction of labour at 39 weeks and chart audit would also reduce costs compared to standard care.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.publisher.placeUnited Kingdom
dc.relation.ispartofjournalPaediatric and Perinatal Epidemiology
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchPaediatrics
dc.subject.fieldofresearchReproductive medicine
dc.subject.fieldofresearchEpidemiology
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.fieldofresearchcode3213
dc.subject.fieldofresearchcode3215
dc.subject.fieldofresearchcode4202
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsPublic, Environmental & Occupational Health
dc.subject.keywordsObstetrics & Gynecology
dc.subject.keywordsPediatrics
dc.titleReducing caesarean delivery: An economic evaluation of routine induction of labour at 39 weeks in low-risk nulliparous women
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationCallander, EJ; Creedy, DK; Gamble, J; Fox, H; Toohill, J; Sneddon, A; Ellwood, D, Reducing caesarean delivery: An economic evaluation of routine induction of labour at 39 weeks in low-risk nulliparous women, Paediatric and Perinatal Epidemiology, 2019
dcterms.dateAccepted2019-11-10
dc.date.updated2020-01-10T00:26:48Z
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.hasfulltextNo Full Text
gro.griffith.authorCreedy, Debra K.
gro.griffith.authorCallander, Emily J.
gro.griffith.authorFox, Haylee
gro.griffith.authorEllwood, David A.
gro.griffith.authorGamble, Jenny A.


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