Candidate for the Lee B. Lusted Student Prize Competition
Purpose: To investigate the cost-effectiveness of the centering pregnancy model (CPM); this model is a proven method of reducing the preterm birth rate, particularly within the African American population.
Method: A decision-analytic model was designed to compare CPM with traditional prenatal care. Probabilities, costs, and utilities associated with term and preterm births were extrapolated from the literature. A baseline preterm birth rate of 12.3% for the general population and 17.5% for non-Hispanic blacks was derived from National Center for Health Statistics data. Level 1 evidence was used to estimate odds ratios for preterm birth rates for participants of CPM versus traditional pregnancy counseling (0.67, 95% CI 0.44-0.99, African Americans 0.59, 95% CI 0.38-0.92). Baseline prenatal care cost estimates, excluding delivery costs, of $4,091 for CPM and $4,194 for traditional prenatal care were obtained from the literature.
Result: CPM is the dominant strategy in the reduction of preterm births. CPM is less costly ($18,857 vs. $20,188) and more effective (26.4557 vs. 26.4508 QALYs) in decreasing preterm births. A threshold value for prenatal care cost was identified: CPM remains cost-effective as long as the prenatal care cost less than $6,070. For African-American women, centering pregnancy remains cost-effective for prenatal care costs less than $7,800.
Conclusion: The centering pregnancy model is less costly and more effective than traditional prenatal care in decreasing preterm births.
| Total costs and QALYs associated with centering pregnancy model and traditional prenatal care | ||
| Cost | QALYs | |
| All participants | ||
| Centering pregnancy model | $18,857 | 26.4557 |
| Traditional prenatal care | $20,188 | 26.4508 |
| African-Americans | ||
| Centering pregnancy model | $19,616 | 26.4532 |
| Traditional prenatal care | $22,089 | 26.4446 |
See more of: The 34th Annual Meeting of the Society for Medical Decision Making