Trial reportPloS one2016
Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.
Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Alternative healthcare delivery arrangements in Nepal: a systematic review of comparative effectiveness, safety and cost-effectiveness studies.BMJ global health · 2025Pooled it
- Medical methods for first trimester abortion.The Cochrane database of systematic reviews · 2022Pooled it
- Effectiveness, safety, and acceptability of first-trimester medical termination of pregnancy performed by non-doctor providers: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2017Pooled it
- "It's Not a One Size Fits All": Service Users' Views on How Service Structure Shapes Quality of Abortion Care in Britain. Findings from the SACHA Study.Studies in family planning · 2026Article
- Are Economic Evaluations of Task Shifting Too Narrow in Focus? A Rapid Review.PharmacoEconomics · 2025Review
- Access to medical abortion and abortion care in Japan.Preventive medicine reports · 2025Article
- Article
- Co-design of a nurse-led model of care to increase access to medical abortion and contraception in rural and regional general practice: A protocol.The Australian journal of rural health · 2022Article
- Dutch GPs' views on prescribing mifepristone and misoprostol: a mixed-methods study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Views and practice of abortion among Queensland midwives and sexual health nurses.The Australian & New Zealand journal of obstetrics & gynaecology · 2022Article
- Abortion in Countries with Restrictive Abortion Laws-Possible Directions and Solutions from the Perspective of Poland.Healthcare (Basel, Switzerland) · 2021Review
- How task-sharing in abortion care became the norm in Sweden: A case study of historic and current determinants and events.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020Article
- Preimplantation genetic testing to reduce preterm births in assisted reproductive technology.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020Review
- The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems.PloS one · 2020Article
- Reporting and Analysis of Trial-Based Cost-Effectiveness Evaluations in Obstetrics and Gynaecology.PharmacoEconomics · 2017Review
- Interest in Medication and Aspiration Abortion Training among Colorado Nurse Practitioners, Nurse Midwives, and Physician Assistants.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established. STUDY
designA cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER) were calculated. The study was conducted at a university hospital in Stockholm, Sweden.
resultsThe average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided.
conclusionEarly medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.