Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study.
Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study.
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DOI：
10.1111/ppe.12906
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发表时间：
2022-09
影响因子：
2.8
通讯作者：
Petrou, Stavros
中科院分区：
文献类型：
--
作者：
Achana, Felix;Johnson, Samantha;Ni, Yanyan;Marlow, Neil;Wolke, Dieter;Khan, Kamran;Petrou, Stavros
早产与不利的健康和发育后遗症有关，给有限的资源带来负担，给个人、家庭和社会带来重大挑战。使用全人群研究(EPICure2研究)的证据来估计11岁时与极早产相关的经济后果。研究人群包括2006年期间在英国≤出生的怀孕26周的儿童样本(n=0.200)和在足月出生的同班同学的对照组(n=1.143)。使用家长和教师关于服务利用率的报告，以及对工作损失和家庭额外护理费用的估值，来估计社会成本。使用英国和加拿大的值集生成卫生实用程序指数标记2(HUI2)和标记3(HUI3)的效用分数。广义线性回归被用来估计极早产对社会成本和效用得分的影响。未调整的平均社会成本(不包括主流学校在出生后第11年提供特殊教育支助)为极早产儿组6536 GB，其同班同学为3275 GB，两者相差3262 GB(95%可信区间[CI]GB 1912，GB 5543)。平均调整成本差异为GB 2916(95%CI GB 1609，GB 4224)，包括主流学校提供特殊教育需要将调整成本差异增加到GB 4772(95%CI GB 3166，GB 6378)。与足月分娩相比，极早产产生的平均调整效用减少从基于英国HUI2统计推断关税的0.13(95%CI 0.09，0.18)到基于加拿大HUI3关税的0.28(95%CI 0.18，0.37)。极早产对经济的不利影响一直持续到儿童后期。需要从多个角度进行进一步的纵向研究，以了解极早产后经济后果的规模、轨迹和基础机制。
Preterm birth is associated with adverse health and developmental sequelae that impose a burden on finite resources and significant challenges for individuals, families and societies. To estimate economic outcomes at age 11 associated with extremely preterm birth using evidence from a whole population study (EPICure2 study). The study population comprised a sample of children born at ≤26 completed weeks of gestation during 2006 in England (n = 200) and a comparison group of classmates born at term (n = 143). Societal costs were estimated using parent and teacher reports of service utilisation, and valuations of work losses and additional care costs to families. Utility scores for the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) were generated using UK and Canadian value sets. Generalised linear regression was used to estimate the impact of extremely preterm birth on societal costs and utility scores. Unadjusted mean societal costs that excluded provision of special educational support in mainstream schools during the 11th year after birth were £6536 for the extremely preterm group and £3275 for their classmates, generating a difference of £3262 (95% confidence interval [CI] £1912, £5543). The mean adjusted cost difference was £2916 (95% CI £1609, £4224), including special educational needs provision in mainstream schools increased the adjusted cost difference to £4772 (95% CI £3166, £6378). Compared with birth at term, extremely preterm birth generated mean‐adjusted utility decrements ranging from 0.13 (95% CI 0.09, 0.18) based on the UK HUI2 statistical inference tariff to 0.28 (95% CI 0.18, 0.37) based on the Canadian HUI3 tariff. The adverse economic impact of extremely preterm birth persists into late childhood. Further longitudinal studies conducted from multiple perspectives are needed to understand the magnitude, trajectory and underpinning mechanisms of economic outcomes following extremely preterm birth.
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DOI：
10.1177/2042018818766816
发表时间：
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影响因子：
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