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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Preventing repeat pregnancy in adolescents: Is immediate postpartum insertion of the contraceptive implant cost effective?
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Preventing repeat pregnancy in adolescents: Is immediate postpartum insertion of the contraceptive implant cost effective?

机译：防止青少年再次怀孕：产后立即插入避孕植入物是否划算？

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Objective The objective of the study was to determine the cost-effectiveness of a hypothetical state-funded program offering immediate postpartum implant (IPI) insertion for adolescent mothers. Study Design Participants in an adolescent prenatal-postnatal program were enrolled in a prospective observational study of IPI insertion (IPI group, n = 171) vs standard contraceptive initiation (comparison group, n = 225). Implant discontinuation, repeat pregnancies and pregnancy outcomes were determined. We compared the anticipated public expenditures for IPI recipients and comparisons at 6, 12, 24, and 36 months postpartum using the actual outcomes of this cohort and Colorado Medicaid reimbursement estimates. Costs were normalized to 1000 adolescents in each arm and included 1 year of well-baby care for delivered pregnancies. Results At 6 months, the expenditures of the IPI group exceed the comparison group by $73,000. However, at 12, 24, and 36 months, publicly funded IPIs would result in a savings of more than $550,000, $2.5 million, and $4.5 million, respectively. For every dollar spent on the IPI program, $0.79, $3.54, and $6.50 would be saved at 12, 24, and 36 months. Expenditures between the IPI and comparison groups would be equal if the comparison group pregnancy rate was 13.8%, 18.6%, and 30.5% at 12, 24, and 36 months. Actual rates were 20.1%, 46.5%, and 83.7%. Conclusion Offering IPIs to adolescent mothers is cost effective. Payors that do not currently cover IPI should integrate these data into policy considerations.
机译：目的本研究的目的是确定一项假设的国家资助计划的成本效益，该计划为青春期母亲提供立即产后植入（IPI）插入。研究设计青春期产前产后程序的参与者参加了IPI插入（IPI组，n = 171）与标准避孕药启动（比较组，n = 225）的前瞻性观察研究。确定了植入物停药，重复妊娠和妊娠结局。我们使用该队列和Colorado Medicaid报销估算的实际结果，比较了IPI接受者的预期公共支出以及在产后6、12、24和36个月的比较。每组的费用标准化为1000名青少年，其中包括为分娩提供的为期1年的婴儿照料。结果在6个月时，IPI组的支出比对照组高出73,000美元。但是，在12、24和36个月时，由公共资助的IPI将分别节省超过55万美元，250万美元和450万美元。在IPI计划上花费的每一美元，将在12、24和36个月时节省$ 0.79，$ 3.54和$ 6.50。如果比较组在12、24和36个月的怀孕率分别为13.8％，18.6％和30.5％，则IPI和比较组之间的支出将相等。实际发生率分别为20.1％，46.5％和83.7％。结论为青春期母亲提供IPI成本效益高。当前不涵盖IPI的付款人应将这些数据整合到政策考虑中。

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