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Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes

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Listed:
  • Weiqin Li
  • Cuiping Zhang
  • Junhong Leng
  • Ping Shao
  • Huiguang Tian
  • Fuxia Zhang
  • Ling Dong
  • Zhijie Yu
  • Juliana C N Chan
  • Gang Hu
  • Ping Zhang
  • Xilin Yang

Abstract

This study assessed within-trial cost-effectiveness of a shared care program (SC, n = 339) for pregnancy outcomes compared to usual care (UC, n = 361), as implemented in a randomized trial of Chinese women with gestational diabetes (GDM). SC consisted of an individualized dietary advice and physical activity counseling program. The UC was a one-time group education program. The effectiveness was measured by number needed to treat (NNT) to prevent one macrosomia/large for gestational age (LGA) infant. The cost-effectiveness was measured by incremental cost-effectiveness ratio in terms of cost (2012 Chinese Yuan/US dollar) per case of macrosomia and LGA prevented. The study took both a health care system and a societal perspective. This study found that the NNT was 16/14 for macrosomia/LGA. The incremental cost for treating a pregnant woman was ¥1,877 ($298) from a health care system perspective and ¥2,056 ($327) from a societal perspective. The cost of preventing a case of macrosomia/LGA from the two corresponding perspectives were ¥30,032/¥26,278 ($4,775/$4,178) and ¥32,896/¥28,784 ($5,230/$4,577), respectively. Considering the potential severe adverse health and economic consequences of a macrosomia/LGA infant, our findings suggest that implementing this lifestyle intervention for women with GDM is an efficient use of health care resources.

Suggested Citation

  • Weiqin Li & Cuiping Zhang & Junhong Leng & Ping Shao & Huiguang Tian & Fuxia Zhang & Ling Dong & Zhijie Yu & Juliana C N Chan & Gang Hu & Ping Zhang & Xilin Yang, 2020. "Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-10, August.
  • Handle: RePEc:plo:pone00:0237738
    DOI: 10.1371/journal.pone.0237738
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    References listed on IDEAS

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    1. Rosenberg, T.J. & Garbers, S. & Lipkind, H. & Chiasson, M.A., 2005. "Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: Differences among 4 racial/ethnic groups," American Journal of Public Health, American Public Health Association, vol. 95(9), pages 1545-1551.
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