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The cost-effectiveness of foetal monitoring with ST analysis
Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
2008 (English)Report (Other academic)
Abstract [en]

How to allocate resources in the health care sector is academically dealt with within the subject of health economics. Economic evaluations are within this area used to compare the costs and effects of medical interventions with the purpose to help decision makers decide how to allocate resources.

Oxygen deficiency in the foetus during birth can lead to severe life long injuries in the child. In high-risk deliveries, there is therefore considered necessary to use foetal surveillance with a scalp electrode and the choice is between surveillance with internal cardiotocography (CTG) and surveillance with ST analysis. The standard procedure is in most hospitals currently CTG, which records the foetal heart rate and the uterine contractions. The second strategy, in this thesis referred to as ST analysis, complements CTG with foetal electrocardiography (ECG) and ST analysis.

The objective of this report is to from a societal perspective determine the costeffectiveness of using ST analysis in complicated deliveries, compared to the use of CTG alone. A cost-utility analysis was performed based on a probabilistic decision model incorporating the relevant strategies and outcomes. The costs and effects of the two different treatment strategies were compared in a decision tree. Discounted costs and quality-adjusted life-years (QALYs) were measured and simulated over a life-time perspective.

The analysis resulted in an incremental effect of 0.005 QALYs for the ST analysis strategy, when compared to the CTG strategy. ST analysis was also associated with a €30 lower cost. Thus, CTG is dominated by the ST analysis strategy. The probability that ST analysis is the cost-effective alternative is high for all values of willingness-to-pay for a QALY, which means that a decision to implement the ST analysis strategy based on the results of this thesis would be surrounded by a low degree of uncertainty.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2008. , 39 p.
CMT Report, ISSN 0283-1228 (print), 1653-7556 (online) ; 2007:8
Keyword [en]
ST analysis, cardiotocography, CTG, cerebral palsy, costeffectiveness, cost-utility, decision model, foetal monitoring
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-44514ISRN: LIU CMT RA/0708; LIU-IEI-FIL-A--07/00166--SELocal ID: 76941OAI: diva2:265376
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-02-24Bibliographically approved

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