Logo image
Back
Induction of labor using prostaglandin vaginal gel: Cost analysis comparing early amniotomy with repeat prostaglandin gel
Journal article   Peer reviewed

Induction of labor using prostaglandin vaginal gel: Cost analysis comparing early amniotomy with repeat prostaglandin gel

M Beckmann, Katharina Merollini, S Kumar and V Flenady
European Journal of Obstetrics & Gynecology and Reproductive Biology, Vol.199, pp.96-101
2016
DOI: https://doi.org/10.1016/j.ejogrb.2016.01.041
url
https://doi.org/10.1016/j.ejogrb.2016.01.041View
Published Version

Abstract

cervical ripening cost analysis dinoprostone health care costs labor, induced
Background: In a randomized controlled trial of two policies for induction of labor (IOL) using Prostaglandin E2 (PGE2) vaginal gel, women who had an earlier amniotomy experienced a shorter IOL-to-birth time. Objective: To report the cost analysis of this trial and determine if there are differences in healthcare costs when an early amniotomy is performed as opposed to giving more PGE2 vaginal gel, for women undergoing IOL at term. Study design: Following an evening dose of PGE2 vaginal gel, 245 women with live singleton pregnancies, ≥37+0 weeks, were randomized into an amniotomy or repeat-PGE2 group. Healthcare costs were a secondary outcome measure, sourced from hospital finance systems and included staff costs, equipment and consumables, pharmacy, pathology, hotel services and business overheads. A decision analytic model, specifically a Markov chain, was developed to further investigate costs, and a Monte Carlo simulation was performed to confirm the robustness of these findings. Mean and median costs and cost differences between the two groups are reported, from the hospital perspective. Results: The healthcare costs associated with IOL were available for all 245 trial participants. A 1000-patient cohort simulation demonstrated that performing an early amniotomy was associated with a cost-saving of $AUD289 ($AUD7094 vs $AUD7338) per woman induced, compared with administering more PGE2. Propagating the uncertainty through the model 10,000 times, early amniotomy was associated with a median cost savings of $AUD487 (IQR -$AUD573, +$AUD1498). Conclusions: After an initial dose of PGE2 vaginal gel, a policy of administering more PGE2 when the Modified Bishop's score is <7 was associated with increased healthcare costs compared with a policy of performing an amniotomy, if technically possible. Length of stay was the main driver of healthcare costs. © 2016 Elsevier Ireland Ltd.

Details

Metrics

470 Record Views
7 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
Web Of Science research areas
Obstetrics & Gynecology
Reproductive Biology

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

Source: InCites

Logo image