Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective
BACKGROUND: Preterm birth is the leading cause of morbidity and mortality for children under five years with First Nations babies experiencing twice the rate of other Australians. The Birthing in Our Community (BiOC) service was implemented in a metropolitan centre in Australia and showed a signific...
Published in: | The Lancet Regional Health - Western Pacific |
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ftpubmed:oai:pubmedcentral.nih.gov:10240371 2023-07-02T03:32:16+02:00 Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective Gao, Yu Roe, Yvette Hickey, Sophie Chadha, Anvitaa Kruske, Sue Nelson, Carmel Carson, Adrian Watego, Kristie Reynolds, Maree Costello, Jo Tracy, Sally Kildea, Sue 2023-03-03 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240371/ http://www.ncbi.nlm.nih.gov/pubmed/37283966 https://doi.org/10.1016/j.lanwpc.2023.100722 en eng Elsevier http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240371/ http://www.ncbi.nlm.nih.gov/pubmed/37283966 http://dx.doi.org/10.1016/j.lanwpc.2023.100722 © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Lancet Reg Health West Pac Articles Text 2023 ftpubmed https://doi.org/10.1016/j.lanwpc.2023.100722 2023-06-11T00:49:04Z BACKGROUND: Preterm birth is the leading cause of morbidity and mortality for children under five years with First Nations babies experiencing twice the rate of other Australians. The Birthing in Our Community (BiOC) service was implemented in a metropolitan centre in Australia and showed a significant reduction in preterm birth. We aimed to assess the cost-effectiveness of the BiOC service in reducing preterm births compared to Standard Care, from a health system perspective. METHODS: Women who were carrying a First Nations baby and attending the Mater Mothers Public Hospital (Brisbane, QLD, Australia) were allocated to either BiOC or Standard Care service. Birth records were extracted from the hospital's routinely collected and prospectively entered database. The time horizon extended from first presentation in pregnancy up to six weeks after birth for mothers and 28 days for infants, or until discharged from hospital. All direct antenatal, birth, postnatal and neonatal costs were included. The proportion of preterm birth was calculated, and cost was estimated in 2019 Australian dollars. The incremental cost and proportion of preterm birth differences were adjusted using inverse probability of treatment weighting methods. FINDINGS: Between Jan 1 2013, and Jun 30, 2019, 1816 mothers gave births to 1867 First Nations babies at the Mater Mothers Public Hospital. After exclusions, 1636 mother-baby pairs were included in the analyses: 840 in the Standard Care group and 796 in the BiOC service. Relative to Standard Care, the BiOC service was associated with a reduced proportion of preterm birth (−5.34%, [95% CI −8.69%, −1.98%]) and cost savings (-AU$4810, [95% CI −7519, −2101]) per mother-baby pair. The BiOC service was associated with better outcomes and cost less than Standard Care. INTERPRETATION: The BiOC service offers a cost-effective alternative to Standard Care in reducing preterm birth for Australian First Nations families. The cost savings were driven by less interventions and procedures in birth and fewer ... Text First Nations PubMed Central (PMC) Brisbane ENVELOPE(-45.633,-45.633,-60.600,-60.600) The Lancet Regional Health - Western Pacific 34 100722 |
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Articles Gao, Yu Roe, Yvette Hickey, Sophie Chadha, Anvitaa Kruske, Sue Nelson, Carmel Carson, Adrian Watego, Kristie Reynolds, Maree Costello, Jo Tracy, Sally Kildea, Sue Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
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Articles |
description |
BACKGROUND: Preterm birth is the leading cause of morbidity and mortality for children under five years with First Nations babies experiencing twice the rate of other Australians. The Birthing in Our Community (BiOC) service was implemented in a metropolitan centre in Australia and showed a significant reduction in preterm birth. We aimed to assess the cost-effectiveness of the BiOC service in reducing preterm births compared to Standard Care, from a health system perspective. METHODS: Women who were carrying a First Nations baby and attending the Mater Mothers Public Hospital (Brisbane, QLD, Australia) were allocated to either BiOC or Standard Care service. Birth records were extracted from the hospital's routinely collected and prospectively entered database. The time horizon extended from first presentation in pregnancy up to six weeks after birth for mothers and 28 days for infants, or until discharged from hospital. All direct antenatal, birth, postnatal and neonatal costs were included. The proportion of preterm birth was calculated, and cost was estimated in 2019 Australian dollars. The incremental cost and proportion of preterm birth differences were adjusted using inverse probability of treatment weighting methods. FINDINGS: Between Jan 1 2013, and Jun 30, 2019, 1816 mothers gave births to 1867 First Nations babies at the Mater Mothers Public Hospital. After exclusions, 1636 mother-baby pairs were included in the analyses: 840 in the Standard Care group and 796 in the BiOC service. Relative to Standard Care, the BiOC service was associated with a reduced proportion of preterm birth (−5.34%, [95% CI −8.69%, −1.98%]) and cost savings (-AU$4810, [95% CI −7519, −2101]) per mother-baby pair. The BiOC service was associated with better outcomes and cost less than Standard Care. INTERPRETATION: The BiOC service offers a cost-effective alternative to Standard Care in reducing preterm birth for Australian First Nations families. The cost savings were driven by less interventions and procedures in birth and fewer ... |
format |
Text |
author |
Gao, Yu Roe, Yvette Hickey, Sophie Chadha, Anvitaa Kruske, Sue Nelson, Carmel Carson, Adrian Watego, Kristie Reynolds, Maree Costello, Jo Tracy, Sally Kildea, Sue |
author_facet |
Gao, Yu Roe, Yvette Hickey, Sophie Chadha, Anvitaa Kruske, Sue Nelson, Carmel Carson, Adrian Watego, Kristie Reynolds, Maree Costello, Jo Tracy, Sally Kildea, Sue |
author_sort |
Gao, Yu |
title |
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
title_short |
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
title_full |
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
title_fullStr |
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
title_full_unstemmed |
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective |
title_sort |
birthing on country service compared to standard care for first nations australians: a cost-effectiveness analysis from a health system perspective |
publisher |
Elsevier |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240371/ http://www.ncbi.nlm.nih.gov/pubmed/37283966 https://doi.org/10.1016/j.lanwpc.2023.100722 |
long_lat |
ENVELOPE(-45.633,-45.633,-60.600,-60.600) |
geographic |
Brisbane |
geographic_facet |
Brisbane |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Lancet Reg Health West Pac |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240371/ http://www.ncbi.nlm.nih.gov/pubmed/37283966 http://dx.doi.org/10.1016/j.lanwpc.2023.100722 |
op_rights |
© 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
op_doi |
https://doi.org/10.1016/j.lanwpc.2023.100722 |
container_title |
The Lancet Regional Health - Western Pacific |
container_volume |
34 |
container_start_page |
100722 |
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1770271799006724096 |