A structured review and exploration of the healthcare costs associated with stillbirth and a subsequent pregnancy in England and Wales

BMC Pregnancy and Childbirth

Tracy Roberts²  Oluwaseyi Vincent³  Alexander E P Heazell¹  Hema Mistry² 

[1] Manchester Academic Health Science Centre, St Mary’s Hospital, Oxford Road, Manchester M13 9WL, UK;Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;York Health Economics Consortium, University of York, York YO10 5NH, UK

关键词: NHS;    Multiparous women;    Stillbirth;    Costs and cost analysis;   

Others  :  1131884
DOI  :  10.1186/1471-2393-13-236

 received in 2013-06-17, accepted in 2013-12-09,  发布年份 2013

【 摘 要 】

Background

In contrast to other pregnancy complications the economic impact of stillbirth is poorly understood. We aimed to carry out a preliminary exploration of the healthcare costs of stillbirth from the time of pregnancy loss and the period afterwards; also to explore and include the impact of a previous stillbirth on the healthcare costs of the next pregnancy.

Methods

A structured review of the literature including cost studies and description of costs to health-care providers for care provided at the time of stillbirth and in a subsequent pregnancy. Costs in a subsequent pregnancy were compared in three alternative models of care for multiparous women developed from national guidelines and expert opinion: i) “low risk” women who had a live birth, ii) “high risk” women who had a live birth and iii) women with a previous stillbirth.

Results

The costs to the National Health Service (NHS) for investigation immediately following stillbirth ranged from £1,242 (core recommended investigations) to £1,804 (comprehensive investigation). The costs in the next pregnancy following a stillbirth ranged from £2,147 (low-risk woman with a previous healthy child) to £3,751 (Woman with a previous stillbirth of unknown cause). The cost in the next pregnancy following a stillbirth due to a known recurrent or an unknown cause is almost £500 greater than the pregnancy following a stillbirth due to a known non-recurrent cause.

Conclusions

The study has highlighted the paucity of evidence regarding economic issues surrounding stillbirth. Women who have experienced a previous stillbirth are likely to utilise more health care services in their next pregnancy particularly where no cause is found. Every effort should be made to determine the cause of stillbirth to reduce the overall cost to the NHS. The cost associated with identifying the cause of stillbirth could offset the costs of care in the next pregnancy. Future research should concentrate on robust studies looking into the wider economic impact of stillbirth.

【 授权许可】

   
2013 Mistry et al.; licensee BioMed Central Ltd.

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