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Achana et al_PPE2022_ Economic costs and health utility values associated with EP birth EPICure2.pdf (563.39 kB)

Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study.

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posted on 2022-08-31, 14:54 authored by Felix Achana, Samantha Johnson, Yanyan Ni, Neil Marlow, Dieter Wolke, Kamran Khan, Stavros Petrou

Background: Preterm birth is associated with adverse health and developmental se-quelae that impose a burden on finite resources and significant challenges for indi-viduals, families and societies.

Objectives: To estimate economic outcomes at age 11 associated with extremely pre-term birth using evidence from a whole population study (EPICure2 study).

Methods: The study population comprised a sample of children born at ≤26 com-pleted weeks of gestation during 2006 in England (n=  200) and a comparison group of classmates born at term (n=  143). Societal costs were estimated using parent and teacher reports of service utilisation, and valuations of work losses and additional care costs to families. Utility scores for the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) were generated using UK and Canadian value sets. Generalised linear regression was used to estimate the impact of extremely preterm birth on societal costs and utility scores.

Results: Unadjusted mean societal costs that excluded provision of special educa-tional support in mainstream schools during the 11th year after birth were £6536 for the extremely preterm group and £3275 for their classmates, generating a difference of £3262 (95% confidence interval [CI] £1912, £5543). The mean adjusted cost dif-ference was £2916 (95% CI £1609, £4224), including special educational needs pro-vision in mainstream schools increased the adjusted cost difference to £4772 (95% CI £3166, £6378). Compared with birth at term, extremely preterm birth generated mean-    adjusted utility decrements ranging from 0.13 (95% CI 0.09, 0.18) based on the UK HUI2 statistical inference tariff to 0.28 (95% CI 0.18, 0.37) based on the Canadian HUI3 tariff.

Conclusions: The adverse economic impact of extremely preterm birth persists into late childhood. Further longitudinal studies conducted from multiple perspectives are needed to understand the magnitude, trajectory and underpinning mechanisms of economic outcomes following extremely preterm birth.

Funding

European Commission, Grant Number: 733280; NIHR Senior Investigator, Grant Number: NF-SI-0616-10103

History

Citation

Paediatr Perinat Epidemiol. 2022;36:696–705

Author affiliation

Department of Health Sciences

Version

  • VoR (Version of Record)

Published in

Paediatric and perinatal epidemiology

Volume

36

Issue

5

Pagination

696–705

Publisher

Wiley

issn

0269-5022

eissn

1365-3016

Acceptance date

2022-05-22

Copyright date

2022

Available date

2022-08-31

Spatial coverage

England

Language

eng

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