Christopher Wai Hung Yau1,2, Erik Lenguerrand1, Steve Morris3, Tim Draycott2, Elena Pizzo4. 1. Translational Health Sciences, University of Bristol, Bristol, United Kingdom. 2. Southmead Hospital, Bristol, United Kingdom. 3. Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. 4. Department of Applied Health Research, University College London, London, United Kingdom.
Abstract
OBJECTIVE: To determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies-Practical Obstetric Multi-Professional Training (PROMPT)-with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs). DESIGN: A model-based cost-utility analysis. SETTING: Maternity units in England. POPULATION: Simulated cohorts of individuals affected by permanent OBPIs. METHODS: A decision tree model was developed to estimate the cost-utility of adopting annual, PROMPT training (scenario 1a) or standalone shoulder dystocia training (scenario 1b) in all maternity units in England compared to current practice, where only a proportion of English units use the training programme (scenario 2). The time horizon was 30 years and the analysis was conducted from an English National Health Service (NHS) and Personal Social Services perspective. A probabilistic sensitivity analysis was performed to account for uncertainties in the model parameters. MAIN OUTCOME MEASURES: Outcomes for the entire simulated period included the following: total costs for PROMPT or shoulder dystocia training (including costs of OBPIs), number of OBPIs averted, number of affected adult/parental/dyadic quality adjusted life years (QALYs) gained and the incremental cost per QALY gained. RESULTS: Nationwide PROMPT or shoulder dystocia training conferred significant savings (in excess of £1 billion ($1.5 billion)) compared to current practice, resulting in cost-savings of at least £1 million ($1.5 million) per any type of QALY gained. The probabilistic sensitivity analysis demonstrated similar findings. CONCLUSION: In this model, national implementation of multi-professional simulation training for obstetric emergencies (or standalone shoulder dystocia training) in England appeared to both be cost-saving when evaluating their impact on permanent OBPIs.
OBJECTIVE: To determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies-Practical Obstetric Multi-Professional Training (PROMPT)-with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs). DESIGN: A model-based cost-utility analysis. SETTING: Maternity units in England. POPULATION: Simulated cohorts of individuals affected by permanent OBPIs. METHODS: A decision tree model was developed to estimate the cost-utility of adopting annual, PROMPT training (scenario 1a) or standalone shoulder dystocia training (scenario 1b) in all maternity units in England compared to current practice, where only a proportion of English units use the training programme (scenario 2). The time horizon was 30 years and the analysis was conducted from an English National Health Service (NHS) and Personal Social Services perspective. A probabilistic sensitivity analysis was performed to account for uncertainties in the model parameters. MAIN OUTCOME MEASURES: Outcomes for the entire simulated period included the following: total costs for PROMPT or shoulder dystocia training (including costs of OBPIs), number of OBPIs averted, number of affected adult/parental/dyadic quality adjusted life years (QALYs) gained and the incremental cost per QALY gained. RESULTS: Nationwide PROMPT or shoulder dystocia training conferred significant savings (in excess of £1 billion ($1.5 billion)) compared to current practice, resulting in cost-savings of at least £1 million ($1.5 million) per any type of QALY gained. The probabilistic sensitivity analysis demonstrated similar findings. CONCLUSION: In this model, national implementation of multi-professional simulation training for obstetric emergencies (or standalone shoulder dystocia training) in England appeared to both be cost-saving when evaluating their impact on permanent OBPIs.
Authors: Christopher W H Yau; Elena Pizzo; Steve Morris; David E Odd; Cathy Winter; Timothy J Draycott Journal: Acta Obstet Gynecol Scand Date: 2016-10 Impact factor: 3.636
Authors: Aimee K Gardner; Dmitry Nepomnayshy; Craig Reickert; Denise W Gee; Ryan Brydges; James R Korndorffer; Daniel J Scott; Ajit K Sachdeva Journal: Surgery Date: 2016-05-17 Impact factor: 3.982
Authors: G Evans-Jones; S P J Kay; A M Weindling; G Cranny; A Ward; A Bradshaw; C Hernon Journal: Arch Dis Child Fetal Neonatal Ed Date: 2003-05 Impact factor: 5.747
Authors: Christopher W H Yau; Elena Pizzo; Chetankumar Prajapati; Tim Draycott; Erik Lenguerrand Journal: Health Qual Life Outcomes Date: 2018-11-15 Impact factor: 3.186