Economic evaluation of enhanced staff contact for the promotion of breastfeeding for low birth weight infants

• Published in: International journal of technology assessment in health care 2010-04, Vol.26 (2), p.133-140
• Main Authors: Rice, Stephen J. C., Craig, Dawn, McCormick, Felicia, Renfrew, Mary J., Williams, Anthony F.
• Format: Article
• Language: English
• Subjects: Babies; Birth weight; Breast Feeding; Breastfeeding & lactation; Breastmilk; Clinical outcomes; Cost analysis; Cost control; Cost-Benefit Analysis; Cost-effectiveness; Data Collection; Decision Trees; England - epidemiology; Health Care Costs; Health technology assessment; Humans; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Infants; Intervention; Low birth weight; Medical Staff; Mothers; Population; Professional-Patient Relations; Public health; Quality-Adjusted Life Years; Review Literature as Topic; Sepsis; Staff contact; Wales - epidemiology
• ISSN: 0266-4623; 1471-6348
• DOI: 10.1017/S0266462310000115

Objectives: There is evidence that breastmilk feeding reduces mortality and short and long-term morbidity among infants born too soon or too small. The aim of this study was to evaluate the cost-effectiveness of enhanced staff contact for mothers with infants in a neonatal unit with a birth weight of 500–2,500 g from the perspective of the UK National Health Service. Methods: A decision-tree model linked clinical outcomes with long-term health outcomes. The study population was divided into three weight bands: 500–999 g, 1000–1,749 g, and 1,750–2,500 g. Clinical and resource use data were obtained from literature reviews. The measure of benefit was quality-adjusted life-years. Uncertainty was evaluated using cost-effectiveness acceptability curves and sensitivity analyses. Results: The intervention was less costly and more effective than the comparator in the base–case analysis for each birth weight group. The results were quite robust to the sensitivity analyses performed. Conclusions: This is the first economic evaluation in this complex field and offers a model to be developed in future research. The results provide preliminary indications that enhanced staff contact may be cost-effective. However, the limited evidence available, and the limited UK data in particular, suggest that further research is required to provide results with confidence.