METHODS: The cost-effectiveness of the PIN programme versus SAU was assessed from an Irish health and social care perspective over a 24-month timeframe and within the context of a non-randomised, controlled before-and-after trial. In total, 163 parent-infant dyads were included in the study (86 intervention, 77 control). The primary outcome measure for the economic evaluation was the Parenting Sense of Competence Scale (PSOC).
RESULTS: The average cost of the PIN programme was €647 per dyad. The mean (SE) cost (including programme costs) was €7,027 (SE €1,345) compared to €4,811 (SE €593) in the control arm, generating a (non-significant) mean cost difference of €2,216 (bootstrap 95% CI -€665 to €5,096; p = 0.14). The mean incremental cost-effectiveness of the PIN service was €614 per PSOC unit gained (bootstrap 95% CI €54 to €1,481). The probability that the PIN programme was cost-effective, was 87% at a willingness-to-pay of €1,000 per one unit change in the PSOC.
CONCLUSIONS: Our findings suggest that the PIN programme was cost-effective at a relatively low willingness-to-pay threshold when compared to SAU. This study addresses a significant knowledge gap in the field of early intervention by providing important real world evidence on the implementation costs and cost-effectiveness of a universal early years parenting programme. The challenges involved in assessing the cost-effectiveness of preventative interventions for very young children and their parents are also discussed.
BACKGROUND: ISRCTN17488830 (Date of registration: 27/11/15). This trial was retrospectively registered.
方法:在24个月的时间范围内,从爱尔兰健康和社会护理的角度评估了PIN计划与SAU的成本效益,试验前后控制。总的来说,163个父母-婴儿二元组被纳入研究(86个干预措施,77控制)。经济评估的主要结果指标是父母能力感量表(PSOC)。
结果:PIN程序的平均成本为每dyad647欧元。平均(SE)成本(包括计划成本)为7,027欧元(1,345欧元),而控制臂为4,811欧元(593欧元),产生(非显著)平均成本差异为2216欧元(Bootstrap95%CI-665欧元至5096欧元;p=0.14)。PIN服务的平均增量成本效益为每PSOC单位获得614欧元(引导95%CI为54欧元至1,481欧元)。密码方案具有成本效益的可能性,在PSOC的每一单位变更中,愿意支付1000欧元的比例为87%。
结论:我们的研究结果表明,与SAU相比,PIN计划在相对较低的支付意愿阈值下具有成本效益。本研究通过提供有关普遍早年育儿计划的实施成本和成本效益的重要现实世界证据,解决了早期干预领域的重大知识差距。还讨论了评估幼儿及其父母的预防性干预措施的成本效益所面临的挑战。
背景:ISRCTN17488830(注册日期:27/11/15)。该试验是回顾性注册的。