Evidence map›Paper›PMID 34873002›Full record

Trial reportBMJ open2021

Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years.

Shalika Bohingamu Mudiyanselage, Anna M H Price, Fiona K Mensah, Hannah E Bryson, Susan Perlen, Francesca Orsini, Harriet Hiscock, Penelope Dakin, Diana Harris, Kristy Noble and 4 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 2 countries.

Shalika Bohingamu MudiyanselageSchool of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia shalika.b@deakin.edu.au.ORCID 0000-0003-1090-4401
Anna M H PricePopulation Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.ORCID 0000-0002-8117-8059
Fiona K MensahPopulation Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.ORCID 0000-0002-6951-9949
Hannah E BrysonPopulation Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.ORCID 0000-0002-3294-620X
Susan PerlenPopulation Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.ORCID 0000-0001-7814-9743
Francesca OrsiniClinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia.ORCID 0000-0001-5183-5946
Harriet HiscockCentre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia.ORCID 0000-0003-3017-2770
Penelope DakinAustralian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia.
Diana HarrisAustralian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia.ORCID 0000-0001-5282-9521
Kristy NobleAustralian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia.
Tracey BruceIngham Institute, Western Sydney University, Penrith, NSW, 2751, Australia.ORCID 0000-0003-0546-5547
Lynn KempIngham Institute, Western Sydney University, Penrith, NSW, 2751, Australia.
Sharon GoldfeldPopulation Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.ORCID 0000-0001-6520-7094
Lisa GoldSchool of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia.ORCID 0000-0002-2733-900X
Royal Children's Hospital · AUDeakin University · AUIngham Institute · AUThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the additional programme cost and cost-effectiveness of 'right@home' Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care.

designA cost-utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation.

settingThe right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years.

participants722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359). PRIMARY AND SECONDARY OUTCOME MEASURES: First, a cost-consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost-utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained.

resultsWhen compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI -0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY.

conclusionsBenefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time. TRIAL REGISTRATION NUMBER: ISRCTN89962120.

Indexed as

ParentingRacial GroupsChild, PreschoolCost-Benefit AnalysisFemaleHome Health NursingHumansPregnancyQuality-Adjusted Life YearsQuality of LifeVictoriacommunity child healthhealth economicsprimary carepublic health

Identifiers

PMID34873002
PMCPMC8650480
OpenAlexW4200586918

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.