title: Evaluation of the cost-effectiveness of home monitoring of uterine contractions.
abstract: In 1988, the major health insurance carrier in the state of Hawaii initiated a prospective study to determine the cost-effectiveness of ambulatory uterine activity monitoring. At the end of the study, 79 patients had completed 3189 days on the monitor. Thirty-six patients (45.6%) did not have preterm labor; the daily monitoring resulted in an average loss to the insurance carrier of $3300 per patient, or $118,800. Forty-three patients (54.4%) experienced preterm labor and were found to have benefited from the monitoring system. Earlier detection of preterm labor and better management of oral tocolysis in this group resulted in earlier initiation of maternal tocolytic therapy, which ultimately decreased the preterm birth rate and hospitalization days in the neonatal intensive care unit. Cost analysis of this group demonstrated an average savings of $24,000 per patient, or an overall savings of $1,032,000. The total group of high-risk patients (79) resulted in a net savings to the insurance carrier of $913,200, or $11,500 per patient, suggesting that use of the ambulatory uterine activity monitoring system significantly reduced the cost associated with preterm labor and early delivery.
authors.affiliation: Hawaii Medical Services Association, Honolulu.
authors.forename: T S
authors.initials: TS
authors.lastname: Kosasa
authors.forename: F K
authors.initials: FK
authors.lastname: Abou-Sayf
authors.forename: G
authors.initials: G
authors.lastname: Li-Ma
authors.forename: R W
authors.initials: RW
authors.lastname: Hale
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D005865:Gestational Age; D006254:Hawaii; D006801:Humans; D007231:Infant, Newborn; D007348:Insurance, Health / Q000191:economics*; D007363:Intensive Care Units, Neonatal / Q000191:economics; D007902:Length of Stay; D008991:Monitoring, Physiologic / Q000191:economics*; D007752:Obstetric Labor, Premature / Q000191:economics* / Q000517:prevention & control; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000502:physiology; D011446:Prospective Studies; D012648:Self Care / Q000191:economics*; D014481:United States; D014590:Uterine Contraction / Q000502:physiology*