Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

What is the economic cost of providing an all Wales postpartum haemorrhage quality improvement initiative (OBS Cymru)? A cost-consequences comparison with standard care

Dale, Megan, Bell, Sarah F., O’Connell, Susan, Scarr, Cerys, James, Kathryn, John, Miriam, Collis, Rachel E., Collins, Peter W. ORCID: https://orcid.org/0000-0002-6410-1324 and Carolan-Rees, Grace 2022. What is the economic cost of providing an all Wales postpartum haemorrhage quality improvement initiative (OBS Cymru)? A cost-consequences comparison with standard care. PharmacoEconomics - Open 6 , pp. 847-857. 10.1007/s41669-022-00362-2

[thumbnail of 41669_2022_362_MOESM1_ESM.pdf] PDF - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (120kB)
[thumbnail of 41669_2022_362_MOESM2_ESM.pdf] PDF - Supplemental Material
Available under License Creative Commons Attribution Non-commercial.

Download (202kB)
[thumbnail of 41669_2022_Article_362.pdf] PDF - Supplemental Material
Available under License Creative Commons Attribution Non-commercial.

Download (885kB)

Abstract

Background and Objective: A postpartum haemorrhage quality improvement initiative (the Obstetric Bleeding Strategy for Wales [OBS Cymru]), including about 60,000 maternities, was adopted across Wales (2017–2018). We performed a cost-consequences analysis to inform ongoing provision and wider uptake. Methods: Analysis was based on primary data from the All Wales postpartum haemorrhage database, with a UK National Health Services perspective, a time horizon from delivery until hospital discharge and no discounting. Costs were based on UK published sources with viscoelastic haemostatic assay costs provided by the OBS Cymru national team. Mean costs per eligible patient (postpartum haemorrhage > 1000 mL) were calculated for OBS Cymru, using the early implementation period as a comparator. Modelling allowed comparisons of three scenarios (two predefined and one post hoc) and implementation in different sizes of maternity unit. Results: All analyses demonstrated consistent savings in blood products, critical care and haematology time, and also a reduced occurrence of massive postpartum haemorrhage (> 2500 mL). Incremental postnatal length of stay varied between scenarios, substantially impacting on total costs. Mean incremental cost of OBS Cymru, compared with standard care, across Wales was £18.41 per patient (postpartum haemorrhage > 1000 mL) or − £10.66 if the length of stay was excluded. Modelling a maternity unit of 5000 births per annum, OBS Cymru incurred an incremental cost of £9.53 per patient with postpartum haemorrhage > 1000 mL. Conclusions: OBS Cymru reduces the occurrence of massive postpartum haemorrhage, need for transfusions, quantity of blood products and intensive care. In medium-to-large maternity units (>3000 maternities per annum), the OBS Cymru intervention approaches cost neutrality compared to standard care.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc/4.0/, Type: open-access
Publisher: Springer
ISSN: 2509-4262
Date of First Compliant Deposit: 26 October 2022
Date of Acceptance: 31 July 2022
Last Modified: 11 Oct 2023 17:12
URI: https://orca.cardiff.ac.uk/id/eprint/153805

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics