Economic evaluation of enhanced staff contact for the promotion of breastfeeding for low birth weight infants.
OBJECTIVE
There is evidence that breastmilk feeding reduces mortality and short and long-term morbidity among infants born too soon or too small. The aim of this study was to evaluate the cost-effectiveness of enhanced staff contact for mothers with infants in a neonatal unit with a birth weight of 500-2,500 g from the perspective of the UK National Health Service.


METHODS
A decision-tree model linked clinical outcomes with long-term health outcomes. The study population was divided into three weight bands: 500-999 g, 1000-1,749 g, and 1,750-2,500 g. Clinical and resource use data were obtained from literature reviews. The measure of benefit was quality-adjusted life-years. Uncertainty was evaluated using cost-effectiveness acceptability curves and sensitivity analyses.


RESULTS
The intervention was less costly and more effective than the comparator in the base-case analysis for each birth weight group. The results were quite robust to the sensitivity analyses performed.


CONCLUSIONS
This is the first economic evaluation in this complex field and offers a model to be developed in future research. The results provide preliminary indications that enhanced staff contact may be cost-effective. However, the limited evidence available, and the limited UK data in particular, suggest that further research is required to provide results with confidence.
Rice
Stephen J C
SJ
Centre for Reviews and Dissemination, University of York, Heslington, York, United Kingdom. sjcr1@york.ac.uk
Craig
Dawn
D
McCormick
Felicia
F
Renfrew
Mary J
MJ
Williams
Anthony F
AF
D001942:Breast Feeding; D003362:Cost-Benefit Analysis; D003625:Data Collection; D003663:Decision Trees; D004739:England / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008503:Medical Staff; D011369:Professional-Patient Relations; D019057:Quality-Adjusted Life Years; D012196:Review Literature as Topic; D014852:Wales / Q000453:epidemiology