Economic evaluation of community perinatal care
Perinatal care is often regarded as the cornerstone of health promotion for pregnant women and new mothers. Evidence on the effectiveness and cost-effectiveness of perinatal care interventions for low-risk pregnancies is limited which means that little guidance is available regarding how best to spend health care resources for this group in order to maximise health gains. A RCT in Calgary compared the effectiveness of standard perinatal care with supplementary prenatal care: standard care plus appointments with a Community Nurse Specialist, and a third arm which augments the specialist nursing care with home visits by trained lay advisors. The study provided an estimate of the costs, general health outcomes and the subjective value or 'utility' of the benefits in order to assess the economic efficiency of the interventions. Value was assessed by willingness-to-pay (though the use of a discrete choice experiment). Face to face interviews were held with 300 women.
Outcome and Translation
This study demonstrated that the community perinatal intervention was valued by participants. This led to the development of a group prenatal care intervention which is currently being evaluated.
HERU researchers involved in this research project: Marjon Van der Pol
External Collaborators: A Shiell and S Tough (University of Calgary)
Au, F., Shiell, A., Pol, M. van der., Johnston, DW. and Tough, S. (2006) 'Does supplementary prenatal nursing and home visitation reduce health care costs in the year after childbirth?', Journal of Advanced Nursing, 56, 657-668.
Pol, M. van der., Shiell, A., Au, F., Johnston, D. and Tough, S. (2008) 'Convergent validity between a discrete choice experiment and a direct, open-ended method: comparison of preferred attribute levels and WTP estimates', Social Science & Medicine, 67 (12), 2043-2050.
Pol, M. van der., Shiell, A., Au, F., Johnston, D. and Tough, S. (2010) 'Eliciting individual preferences for health care: a case study of perinatal care', Health Expectations, 13(1), 4-12.
Pol, M. van der., Shiell, A. and Au, F. (2005) 'Discrete choice experiment with a contingent valuation follow-up', HESG, Newcastle, June 2005.
Pol, M. van der., Shiell, A. and Au, F. (2005) 'Discrete choice experiment with a contingent valuation follow-up', 3rd Discrete Choice Workshop: Advancing the Methodology of Discrete Choice Experiments in Health Economics, University of Las Palmas, Gran Canaria, July 2005.
Pol, M and der. and Cairns, JA. (2005) 'Methods for testing the descriptive validity of alternative discounting models', iHEA, Barcelona, July 2005.
Pol, M. van der., Sheill, A. and Au, F. (2006) 'Using open-ended follow-up questions to test the validity of DCE estimates', European Conference on Health Economics, Budapest, July 2006.