Cost Effectiveness of a Community-Delivered Consultation to Improve Infant Sleep Problems and Maternal Well-Being

Sopany Saing; Bonny Parkinson; Jody Church; Stephen Goodall

doi:10.1016/j.vhri.2017.12.004

Cost Effectiveness of a Community-Delivered Consultation to Improve Infant Sleep Problems and Maternal Well-Being

Value Health Reg Issues. 2018 May:15:91-98. doi: 10.1016/j.vhri.2017.12.004. Epub 2018 Mar 30.

Authors

Sopany Saing¹, Bonny Parkinson², Jody Church³, Stephen Goodall³

Affiliations

¹ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia. Electronic address: sopany.saing@chere.uts.edu.au.
² Macquarie University Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia.
³ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia.

PMID: 29605713
DOI: 10.1016/j.vhri.2017.12.004

Abstract

Objectives: To evaluate the cost effectiveness of a community-delivered consultation aimed at improving infant sleep and maternal well-being.

Methods: A decision-analytic model was developed that compared the costs and benefits of an infant sleep consultation with usual care. The effectiveness of the consultation was based on clinical evidence, and improvements in maternal quality of life were estimated by mapping the Edinburgh Postnatal Depression Scale scores to published utility scores. Cost effectiveness was calculated as the incremental cost per quality-adjusted life-year gained (QALY).

Results: The statistically significant improvements in mean Edinburgh Postnatal Depression Scale scores at 4- and 16-month follow-ups were used to estimate the benefit in terms of QALYs. The modeled results demonstrated that the infant sleep consultation is low-cost (A$ 436), more effective in terms of QALYs gained (0.017), and cost-effective. The estimated incremental cost-effectiveness ratio was A$ 4031/QALY gained. The main drivers of the model were the use of early parenting centers and nurse training costs.

Conclusions: Community-based nurse-delivered infant sleep consultations aid infant sleep, improve maternal quality of life, and are cost-effective compared with usual care and lead to improvements in quality of life through a reduction in postnatal depression.

Keywords: cost effectiveness; depression; infant; maternal-child health centers; postpartum; sleep disorder.

MeSH terms

Australia
Community Health Nursing
Cost-Benefit Analysis*
Depression, Postpartum / psychology
Female
Humans
Infant
Mental Health
Mothers / psychology*
Psychiatric Status Rating Scales / statistics & numerical data
Quality of Life
Referral and Consultation*
Sleep Wake Disorders* / therapy