Day care versus inpatient management of XXXX and @entity391 : cost utility analysis of a randomised controlled trial.

@entity1 @entity391 @entity390
OBJECTIVE: To assess the comparative cost effectiveness of day care over inpatient management of @entity390 and @entity391 (NVP). STUDY DESIGN: A cost utility analysis was performed using a decision analytical model in which a Markov model was constructed. The Markov model was primarily populated with data from a recently published randomised controlled trial. Which included pregnant @entity1 presenting to Cork University Maternity Hospital, a tertiary referral maternity hospital, seeking treatment for NVP. Costs and outcomes were estimated from the perspective of the Irish health service (HSE) and @entity1 . A probabilistic sensitivity analysis, using a Monte Carlo simulation, was also performed. A Bayesian Value of Information analysis was used to estimate the value of collecting additional information. RESULTS: When both the healthcare provider and @entity1 's perspective was considered, day care management of NVP remained less costly (mean    985; 95% C.I. 705-1456 vs.    3837 (2124-8466)) and more effective (9.42; 4.19-12.25 vs. 9.49; 4.32-12.39 quality adjusted life years) compared with inpatient management. The Cost Effectiveness Acceptability Curve indicates the probability that day care management is 70% more cost effective compared to inpatient management at a ceiling ratio of    45,000 per QALY, indicating little decision uncertainty. The Bayesian Value of Information analysis indicates there is value in collecting further information; the Expected Value of Perfect Information (EVPI) is estimated to be    5.4 million. CONCLUSION: Day care management of NVP is cost effective compared to inpatient management.
