对用于评估针对服务不足的孕妇和新生儿父母的干预措施的成本计算方法进行范围界定审查。

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-08-22 DOI:10.1186/s12939-024-02252-x
Elizabeth K Darling, Aisha Jansen, Bismah Jameel, Jean-Éric Tarride
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引用次数: 0

摘要

背景:缺乏针对服务不足的围产期人群的干预措施所带来的长期经济效益的证据,会阻碍有关资金的决策。为了优化未来研究的质量,我们研究了采用哪些方法和成本来评估针对医疗条件较差的孕妇和/或新生儿父母的干预措施的价值:我们采用 Arksey 和 O'Malley 所描述的方法进行了一次范围界定审查。我们在八个数据库中进行了系统搜索,并在网上搜索了灰色文献。两名研究人员对结果进行独立筛选,以确定是否符合纳入条件。我们纳入了针对 20 个高收入国家服务不足人群中的孕妇和/或新生儿父母的干预措施的经济评估和成本分析。我们从收录的出版物中提取了有关研究环境、人群、干预措施、研究方法、收录的成本类型以及成本数据来源的数据并制成表格:最终检索于 2024 年 5 月完成。我们确定了 103 篇符合条件的出版物,这些出版物介绍了一系列干预措施,其中最常见的是家访计划(n = 19)、戒烟干预措施(n = 19)、产前护理(n = 11)、围产期心理健康干预措施(n = 11)和药物使用治疗(n = 10),服务于 36 个不同的服务不足人群。四分之一的出版物(n = 25)仅报告了成本分析,77 份为经济评估。大多数出版物(n = 82)考虑了医疗成本,45 份考虑了其他社会成本,14 份仅考虑了项目成本。在 103 项纳入的研究中,只有三分之一(n = 36)考虑了产后一年以上(仅针对孕期干预)或干预结束后的长期成本:针对来自服务不足人群的孕妇和/或新生儿父母的各种干预措施都有可能减少其后代的健康不平等现象。对此类干预措施的经济评估往往有可能低估这些干预措施的长期效益,因为它们没有考虑下游社会成本。我们从现有研究中整理出的下游成本和长期成本清单,可以为未来针对服务不佳的孕妇和新生儿父母的干预措施进行经济分析提供参考。需要全面量化这些干预措施的下游和长期效益,以便为决策提供信息,从而提高健康公平性。
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A scoping review of costing methodologies used to assess interventions for underserved pregnant people and new parents.

Background: Lack of evidence about the long-term economic benefits of interventions targeting underserved perinatal populations can hamper decision making regarding funding. To optimize the quality of future research, we examined what methods and costs have been used to assess the value of interventions targeting pregnant people and/or new parents who have poor access to healthcare.

Methods: We conducted a scoping review using methods described by Arksey and O'Malley. We conducted systematic searches in eight databases and web-searches for grey literature. Two researchers independently screened results to determine eligibility for inclusion. We included economic evaluations and cost analyses of interventions targeting pregnant people and/or new parents from underserved populations in twenty high income countries. We extracted and tabulated data from included publications regarding the study setting, population, intervention, study methods, types of costs included, and data sources for costs.

Results: Final searches were completed in May 2024. We identified 103 eligible publications describing a range of interventions, most commonly home visiting programs (n = 19), smoking cessation interventions (n = 19), prenatal care (n = 11), perinatal mental health interventions (n = 11), and substance use treatment (n = 10), serving 36 distinct underserved populations. A quarter of the publications (n = 25) reported cost analyses only, while 77 were economic evaluations. Most publications (n = 82) considered health care costs, 45 considered other societal costs, and 14 considered only program costs. Only a third (n = 36) of the 103 included studies considered long-term costs that occurred more than one year after the birth (for interventions occurring only in pregnancy) or after the end of the intervention.

Conclusions: A broad range of interventions targeting pregnant people and/or new parents from underserved populations have the potential to reduce health inequities in their offspring. Economic evaluations of such interventions are often at risk of underestimating the long-term benefits of these interventions because they do not consider downstream societal costs. Our consolidated list of downstream and long-term costs from existing research can inform future economic analyses of interventions targeting poorly served pregnant people and new parents. Comprehensively quantifying the downstream and long-term benefits of such interventions is needed to inform decision making that will improve health equity.

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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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