Costs and cost-effectiveness of periviable care

Aaron B. Caughey, David J. Burchfield

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalSeminars in Perinatology
Volume38
Issue number1
DOIs
StatePublished - Feb 1 2014

Keywords

  • Cost-benefit analysis
  • Cost-effectiveness analysis
  • Down syndrome
  • Economics
  • Prenatal diagnosis-economics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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