对于药物治疗妊娠糖尿病的产前胎儿监测的成本效益
Chloe Ramirez Biermann1, Hannah Coggeshall2, Gillian Luevano1
1Department of Obstetrics & Gynecology, The University of Kansas Medical Center, Kansas City, Kansas, USA.
概括
对于药物治疗妊娠糖尿病,在36周开始产前胎儿监测可能是安全和经济有效的. 这种方法可以节省大量的成本,特别是对于没有保险和低收入的患者,而不会增加死产的风险.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 卫生经济学 卫生经济学
- 产科 产科 产科 产科 产科
背景情况:
- 药物治疗妊娠糖尿病 (GDM) 需要仔细的产前胎儿监测.
- 对于在GDM中启动胎儿监测的最佳时间进行了讨论.
- 之前的研究并没有最终确定不同监测开始时间的成本效益.
研究的目的:
- 为了比较在32周开始产前胎儿监测的成本效益与36周对药物治疗的GDM怀孕的成本效益.
- 分析监测时间对死产率和分娩决策的影响.
- 评估与不同监控启动点相关的成本节约.
主要方法:
- 这是一项追溯的队列研究,从2017年至2022年对652例怀孕的药物治疗GDM进行了追溯研究.
- 排除标准包括24周前的诊断,32周前的分娩以及缺少的监测或分娩数据.
- 成本效益分析的重点是死胎和异常生物物理特征 (BPP) 结果,每种BPP的成本为145美元.
主要成果:
- 在研究队列中没有发生死产.
- 从理论上讲,从36周开始监测可以避免所有死产,并且与从32周开始相比,成本更低.
- 每次避免死胎的成本节省因保险状况而异,无保险患者 (17,799美元) 和私人保险患者 (51,572美元) 的节省更高.
结论:
- 在36周开始的产前胎儿监测对于药物治疗的GDM来说似乎是安全的和具有成本效益的,因为在这个队列中没有死产和BPP指示的早产.
- 研究结果表明,有可能改变实践和共同决策,使社会经济地位较低的患者和没有保险的患者受益.
- 进一步的研究可能会根据成本效益和患者特定因素完善最佳监测协议.
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