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Health economics
Research
Cost analysis of the CTLB Study, a multitherapy antenatal education programme to reduce routine interventions in labour
  1. Kate M Levett1,2,
  2. Hannah G Dahlen3,
  3. Caroline A Smith2,
  4. Kenneth William Finlayson4,
  5. Soo Downe4,
  6. Federico Girosi5,6
  1. 1 School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia
  2. 2 National Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, New South Wales, Australia
  3. 3 School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
  4. 4 School of Midwifery and Community Health, University of Central Lancashire (UCLan), Preston, UK
  5. 5 School of Medicine, Centre for Health Research, Western Sydney University, Sydney, New South Wales, Australia
  6. 6 Research, Health Market Quality program, Capital Markets CRC, Sydney, New South Wales, Australia
  1. Correspondence to Dr Kate M Levett; kate.levett{at}nd.edu.au

Abstract

Objective To assess whether the multitherapy antenatal education ‘CTLB’ (Complementary Therapies for Labour and Birth) Study programme leads to net cost savings.

Design Cost analysis of the CTLB Study, using analysis of outcomes and hospital funding data.

Methods We take a payer perspective and use Australian Refined Diagnosis-Related Group (AR-DRG) cost data to estimate the potential savings per woman to the payer (government or private insurer). We consider scenarios in which the intervention cost is either borne by the woman or by the payer. Savings are computed as the difference in total cost between the control group and the study group.

Results If the cost of the intervention is not borne by the payer, the average saving to the payer was calculated to be $A808 per woman. If the payer covers the cost of the programme, this figure reduces to $A659 since the average cost of delivering the programme was $A149 per woman. All these findings are significant at the 95% confidence level. Significantly more women in the study group experienced a normal vaginal birth, and significantly fewer women in the study group experienced a caesarean section. The main cost saving resulted from the reduced rate of caesarean section in the study group.

Conclusion The CTLB antenatal education programme leads to significant savings to payers that come from reduced use of hospital resources. Depending on which perspective is considered, and who is responsible for covering the cost of the programme, the net savings vary from $A659 to $A808 per woman. Compared with the average cost of birth in the control group, we conclude that the programme could lead to a reduction in birth-related healthcare costs of approximately 9%.

Trial registration number ACTRN12611001126909.

  • cost analysis
  • economic analysis
  • complementary medicine
  • antenatal education
  • caesarean section

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-017333

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    Footnotes

    • Contributors KML was the main contributor to the development, design and conduct of the study, and drafting and revision of the manuscript. FG is the health economist who designed and conducted the analysis for this paper, and drafting and revision of the manuscript. HGD provided mentoring, advice, editing and guidance on the design and manuscript for this study, and was the supervisor for the original overarching study. CAS provided mentoring, advice, editing and guidance on the design and manuscript for this study and was the main supervisor on the original overarching study. KWF and SD provided advice, editing and guidance for this study and review and editing of the manuscript.

    • Funding This article presents independent research, and the principal researcher is funded as a Research Fellow at the University of Notre Dame Australia, School of Medicine, Sydney. The project is supported through the Australian Government’s Collaborative Research Networks (CRN) programme.

    • Competing interests As medical research institutes, the University of Notre Dame Australia, the National Institute of Complementary Medicine at the University of Western Sydney, the School of Midwifery at the University of Western Sydney, and the School of Midwifery and Community Health at the University of Central Lancashire (UCLan) receive research grants and donations from foundations, universities, government agencies, individuals and industry. The project that is the subject of this article was not undertaken as part of a contractual relationship with any organisation.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional data may be available on request by emailing kate.levett@nd.edu.au.