Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss
Abstract
Objective The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss (EPL) treatment beyond expectant management and operating room surgical evacuation (usual care).Study design We constructed a decision model using a hypothetical cohort of women undergoing EPL management within a 30 day horizon. Treatment options under the usual care arm include expectant management and surgical uterine evacuation in an operating room (OR). Treatment options under the expanded care arm included all evidence-based safe and effective treatment options for EPL: expectant management, misoprostol treatment, surgical uterine evacuation in an office setting, and surgical uterine evacuation in an OR. Probabilities of entering various treatment pathways were based on previously published observational studies.Results The cost per case was US $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model (US $1033.29 per case vs US $1274.58 per case, expanded care and usual care, respectively). The model was the most sensitive to the failure rate of the expectant management arm, the cost of the OR surgical procedure, the proportion of women undergoing an OR surgical procedure under usual care, and the additional cost per patient associated with implementing and using the expanded care model.Conclusion This study demonstrates that expanding women's treatment options for EPL beyond what is typically available can result in lower direct medical expenditures.
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The psychological consequences of miscarriage involve both trauma and bereavement.
“The psychological consequences of miscarriage involve both trauma and bereavement. 108”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [108]
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- Authors
- Dalton, V. K., Liang, A., Hutton, D. W., Zochowski, M. K., & Fendrick, A. M.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Dalton, Vanessa K.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 212
- Issue
- 2
- Pages
- 177.e1-177.e6
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2092606933
- Cited by
- 22
- References
- 29
- Citations by year
- 2026: 2 · 2025: 7 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 1
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- early pregnancy loss, miscarriage treatment, expectant management, misoprostol, cost analysis, cost per case
- MeSH terms
- Abortifacient Agents, Nonsteroidal, Abortion, Spontaneous, Ambulatory Surgical Procedures, Dilatation and Curettage, Female, Humans, Operating Rooms, Pregnancy, Pregnancy Trimester, First, Misoprostol, Health Care Costs, Models, Economic, Evidence-Based Medicine, Watchful Waiting
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