| Autor: |
Van den Akker-van Marle, M. E., Rijnders, M. E. B., Van Dommelen, P., Fekkes, M., Van Wouwe, J. P., Amelink-Verburg, M. P., Verkerk, P. H. |
| Předmět: |
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| Zdroj: |
BJOG: An International Journal of Obstetrics & Gynaecology; Jun2005, Vol. 112 Issue 6, p820-826, 7p, 5 Charts, 1 Graph |
| Abstrakt: |
To estimate the costs and effects of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early-onset group B streptococcal (GBS) disease in the Netherlands. The treatment strategies include a risk-based strategy, a screening-based strategy, a combined screening/risk-based strategy and the current Dutch guideline.Cost-effectiveness analysis based on decision model.Obstetric care system in the Netherlands.Hypothetical cohort of 200,000 neonates.A decision analysis model was used to compare the costs and effects of different treatment strategies with no treatment. Baseline estimates were derived from literature and a survey among parents of children affected by GBS disease. The analysis was performed from a societal perspective, and costs and effects were discounted at a percentage of 3%.Cost per quality adjusted of life-year (QALY).The risk-based strategy will prevent 352 cases of early-onset GBS for€5.0 million, indicating a cost-effectiveness ratio of€7600 per QALY gained. The combined screening risk-based strategy has comparable results. The current Dutch guideline resulted in lower effects for higher costs. The screening-based strategy shows the highest reduction in cases of early-onset GBS, however, at a cost-effectiveness ratio of€59,300 per QALY gained. Introducing the polymerase chain reaction (PCR) test may lead to a more favourable cost-effectiveness ratio.In the Dutch system, the combined screening/risk-based strategy and the risk-based strategy have reasonable cost-effectiveness ratios. If it becomes feasible to add the PCR test, the cost-effectiveness of the combined screening/risk-based strategy may even be more favourable. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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