Juan Gabriel Ruiz1, Nathalie Charpak2, Mario Castillo3, Astrid Bernal3, John Ríos3, Tammy Trujillo4, María Adelaida Córdoba5. 1. Department of Clinical Epidemiology and Biostatistics, School of Medicine, Pontificia Universidad Javeriana, Cra 7 #40-62, Hospital Universitario San Ignacio, Piso 2, Bogotá, DC, Colombia; Fundación Canguro, Calle 44b #53-50, Bogotá, DC, Colombia; Servicio de Pediatría, Hospital Universitario San Ignacio, Cra 7 #40-62, Piso 7, Bogotá, DC, Colombia; Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, 11200 SW 8th St. AHC1-344, Miami, FL, 33199, USA. Electronic address: jruiz@javeriana.edu.co. 2. Fundación Canguro, Calle 44b #53-50, Bogotá, DC, Colombia. 3. Departamento de Ingeniería Industrial, Universidad de los Andes, Cra 1 Este #19A-40 Edificio Mario Laserna, Piso 7 Bogotá, DC, Colombia. 4. Department of Clinical Epidemiology and Biostatistics, School of Medicine, Pontificia Universidad Javeriana, Cra 7 #40-62, Hospital Universitario San Ignacio, Piso 2, Bogotá, DC, Colombia. 5. Department of Clinical Epidemiology and Biostatistics, School of Medicine, Pontificia Universidad Javeriana, Cra 7 #40-62, Hospital Universitario San Ignacio, Piso 2, Bogotá, DC, Colombia; Fundación Canguro, Calle 44b #53-50, Bogotá, DC, Colombia.
Abstract
BACKGROUND AND OBJECTIVE: Although kangaroo mother care (KMC) has been shown to be safe and effective in randomized controlled trials (RCTs), there are no published complete economic evaluations including the three components of the full intervention. METHODS: A cost utility analysis performed on the results of an RCT conducted in Bogotá, Colombia between 1993 and 1996. Hospital and ambulatory costs were estimated by microcosting in a sample of preterm infants from a University Hospital in Bogotá in 2011 and at a KMC clinic in the same period. Utility scores were assigned by experts by means of (1) direct ordering and scoring discrete health states and (2) constructing a multi-attribute utility function. Ninety-five percent confidence intervals (CIs) for the incremental cost-utility ratios (ICURs) were computed by the Fiellers theorem method. One-way sensitivity analysis on price estimates for valuing costs was performed. RESULTS:ICUR at 1 year of corrected age was $ -1,546 per extra quality-adjusted life year gained using the KMC method (95% CI $ -7,963 to $ 4,910). CONCLUSION: In Bogotá, the use of KMC is dominant: more effective and cost-saving. Although results from an economic analysis should not be extrapolated to different systems and communities, this dominant result suggests that KMC could be cost-effective in similar low and middle income countries settings.
RCT Entities:
BACKGROUND AND OBJECTIVE: Although kangaroo mother care (KMC) has been shown to be safe and effective in randomized controlled trials (RCTs), there are no published complete economic evaluations including the three components of the full intervention. METHODS: A cost utility analysis performed on the results of an RCT conducted in Bogotá, Colombia between 1993 and 1996. Hospital and ambulatory costs were estimated by microcosting in a sample of preterm infants from a University Hospital in Bogotá in 2011 and at a KMC clinic in the same period. Utility scores were assigned by experts by means of (1) direct ordering and scoring discrete health states and (2) constructing a multi-attribute utility function. Ninety-five percent confidence intervals (CIs) for the incremental cost-utility ratios (ICURs) were computed by the Fiellers theorem method. One-way sensitivity analysis on price estimates for valuing costs was performed. RESULTS: ICUR at 1 year of corrected age was $ -1,546 per extra quality-adjusted life year gained using the KMC method (95% CI $ -7,963 to $ 4,910). CONCLUSION: In Bogotá, the use of KMC is dominant: more effective and cost-saving. Although results from an economic analysis should not be extrapolated to different systems and communities, this dominant result suggests that KMC could be cost-effective in similar low and middle income countries settings.
Authors: Melissa M Medvedev; Victor Tumukunde; Ivan Mambule; Cally J Tann; Peter Waiswa; Ruth R Canter; Christian H Hansen; Elizabeth Ekirapa-Kiracho; Kenneth Katumba; Catherine Pitt; Giulia Greco; Helen Brotherton; Diana Elbourne; Janet Seeley; Moffat Nyirenda; Elizabeth Allen; Joy E Lawn Journal: Trials Date: 2020-01-31 Impact factor: 2.279
Authors: Nathalie Charpak; María I Angel; Deepa Banker; Anne-Marie Bergh; Ana María Bertolotto; Socorro De Leon-Mendoza; Natalia Godoy; Ornella Lincetto; Juan M Lozano; Susan Ludington-Hoe; Goldy Mazia; Mantoa Mokhachane; Adriana Montealegre; Erika Ramirez; Nicole Sirivansanti; Jose Maria Solano; Louise-Tina Day; Maria Esterlita Uy Journal: Acta Paediatr Date: 2020-03-04 Impact factor: 2.299