Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/81213
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Type: Journal article
Title: A cost analysis of inpatient compared with outpatient prostaglandin E₂ cervical priming for induction of labour: results from the OPRA trial
Other Titles: A cost analysis of inpatient compared with outpatient prostaglandin E(2) cervical priming for induction of labour: results from the OPRA trial
Author: Adelson, P.
Wedlock, G.
Wilkinson, C.
Howard, K.
Bryce, R.
Turnbull, D.
Citation: Australian Health Review, 2013; 37(4):467-473
Publisher: Australian Healthcare Association
Issue Date: 2013
ISSN: 0156-5788
1449-8944
Statement of
Responsibility: 
Pamela L. Adelson, Garry R. Wedlock, Chris S. Wilkinson, Kirsten Howard, Robert L. Bryce, Deborah A. Turnbull
Abstract: Objective: To compare the costs of inpatient (usual care) with outpatient (intervention) care for cervical priming for induction of labour in women with healthy, low-risk pregnancies who are being induced for prolonged pregnancies or for social reasons. Methods: Data from a randomised controlled trial at two hospitals in South Australia were matched with hospital financial data. A cost analysis comparing women randomised to inpatient care with those randomised to outpatient care was performed, with an additional analysis focusing on those who received the intervention. Results: Overall, 48% of women randomised into the trial did not receive the intervention. Women randomised to outpatient care had an overall cost saving of $319 per woman (95% CI -$104 to $742) as compared with women randomised to usual care. When restricted to women who actually received the intervention, in-hospital cost savings of $433 (95% CI -$282 to $1148) were demonstrated in the outpatient group. However, these savings were partially offset by the cost of an outpatient priming clinic, reducing the overall cost savings to $156 per woman. Conclusions: Overall cost savings were not statistically significant in women who were randomised to or received the intervention. However, the trend in cost savings favoured outpatient priming. What is known about the topic? Induction of labour is a common obstetric intervention. For women with low-risk, prolonged pregnancies who require cervical priming there has been increased interest in whether this period of waiting for the cervix to ‘ripen’ can be achieved at home. Outpatient priming has been reported to reduce hospital costs and improve maternal satisfaction. However, few studies have actually examined the cost of outpatient priming for induction of labour. What does this paper add? This is the first paper in Australia to both assess the full cost of outpatient cervical priming and to compare it with usual (inpatient) care. This is the first costing paper from a randomised controlled trial directly comparing inpatient and outpatient priming with prostaglandin E2. What are the implications for practitioners? For women with prolonged, low-risk pregnancies, a program of outpatient cervical priming can potentially reduce in-hospital costs and free up labour ward beds by avoiding an additional overnight hospitalisation.
Keywords: cost analysis; outpatient priming; PGE2 priming.
Rights: © AHHA 2013
RMID: 0020131781
DOI: 10.1071/AH13081
Appears in Collections:Psychology publications

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