Health economic evaluation of an electronic mindfulness-based intervention (eMBI) to improve maternal mental health during pregnancy - a randomized controlled trial (RCT).

IF 2.7 3区 经济学 Q1 ECONOMICS
Lena Hasemann, Svenja Elkenkamp, Mitho Müller, Armin Bauer, Stephanie Wallwiener, Wolfgang Greiner
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Abstract

Background: Anxiety and depression are the most prevalent psychiatric diseases in the peripartum period. They can lead to relevant health consequences for mother and child as well as increased health care resource utilization (HCRU) and related costs. Due to the promising results of mindfulness-based interventions (MBI) and digital health applications in mental health, an electronic MBI on maternal mental health during pregnancy was implemented and assessed in terms of transferability to standard care in Germany. The present study focused the health economic outcomes of the randomized controlled trial (RCT).

Methods: The analysis, adopting a payer's and a societal perspective, included women of increased emotional distress at < 29 weeks of gestation. We applied inferential statistics (α = 0.05 significance level) to compare the intervention group (IG) and control group (CG) in terms of HCRU and costs. The analysis was primarily based on statutory health insurance claims data which covered the individual observational period of 40 weeks.

Results: Overall, 258 women (IG: 117, CG: 141) were included in the health economic analysis. The results on total health care costs from a payer's perspective indicated higher costs for the IGi compared to the CG (Exp(ß) = 1.096, 95% CI: 1.006-1.194, p = 0.037). However, the estimation was not significant after Bonferroni correction (p < 0.006). Even the analysis from a societal perspective as well as sensitivity analyses did not show significant results.

Conclusions: In the present study, the eMBI did neither reduced nor significantly increased health care costs. Further research is needed to generate robust evidence on eMBIs for women suffering from peripartum depression and anxiety.

Trial registration: German Clinical Trials Register: DRKS00017210. Registered on 13 January 2020. Retrospectively registered.

改善孕期孕产妇心理健康的电子正念干预(eMBI)的卫生经济评估--随机对照试验(RCT)。
背景:焦虑和抑郁是围产期最常见的精神疾病。它们会给母婴带来相关的健康后果,并增加医疗资源利用率(HCRU)和相关费用。基于正念的干预(MBI)和数字健康应用在心理健康方面取得了可喜的成果,因此在德国实施了一项关于孕期孕产妇心理健康的电子MBI,并评估了其与标准护理的可转换性。本研究的重点是随机对照试验(RCT)的卫生经济成果:方法:从支付方和社会的角度进行分析,将结果中情绪困扰增加的妇女包括在内:共有 258 名妇女(IG:117 人,CG:141 人)被纳入健康经济分析。从支付方的角度来看,医疗总成本结果显示,IGi 的成本高于 CG(Exp(ß) = 1.096,95% CI:1.006-1.194,p = 0.037)。然而,经过 Bonferroni 校正后,估计值并不显著(p 结论:IGi 与 CG 相比具有更高的成本效益:在本研究中,eMBI 既没有降低医疗成本,也没有显著增加医疗成本。需要进一步研究,以获得针对围产期抑郁和焦虑妇女的 eMBI 的可靠证据:试验注册:德国临床试验注册中心:DRKS00017210.注册日期:2020 年 1 月 13 日。追溯注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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