Diet and exercise interventions for pregnant women projected to save Australia’s health budget millions of dollars

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Health economic researchers from Monash University have projected that Australia’s health budget would save approximately AUD$807 million over a five-year period if the country’s maternal health services were to offer structured diet and exercise interventions in pregnancies as a way to curtail adverse maternal and infant outcomes.

The research is important because structured antenatal diet and physical activity interventions have been shown to be effective in reducing adverse pregnancy outcomes, however the health cost implications of population level implementation has remained unclear.

The study was set in Australian health services and focused on all Australian women projected to give birth in the years 2022 to 2026. The economic evaluation was conducted via an open source ‘decision tree’ model to compare the projected budget outcomes of implementing lifestyle intervention vs usual care.

The researchers from Monash’s Centre for Medicine Use and Safety (CMUS), School of Public Health and Preventive Medicine (SPHPM) and Monash Centre for Health Research and Implementation (MCHRI) projected that if a five-year program involving structured diet and physical activity by trained health professionals was integrated into routine antenatal care as an option for all Australian pregnancies, for every Australian dollar spent there would be a return of AUD$4.75 to Australia’s health budget.

In 2019, 48 per cent of pregnant women in Australia were classified as overweight or obese, which is strongly and independently associated with adverse maternal and infant outcomes, including hypertensive disease in pregnancy (HDP) and gestational diabetes.

Health service costs associated with pregnancy and birth in Australia were 25 per cent higher for women with HDP, and 13 per cent for gestational diabetes, compared with those without these conditions.

Associate Professor Zanfina Ademi and Dr Melanie Lloyd from CMUS and SPHPM, lead authors of the study, said recent systematic reviews have shown that structured lifestyle interventions can also translate into improved health and cost outcomes for infants when things like admission to neonatal intensive care are considered.

“The findings from this study suggest that providing access to supportive, structured diet and physical activity lifestyle interventions for all pregnant Australian women may offer substantial health and economic benefits for both women and infants,” said Associate Professor Ademi.

“Given the current restraints on Australia’s health budget and growing pressure on hospitals to curtail spending, assessing projected costs at the system level is essential for the planning and management of Australia’s health budgets.”

Dr Lloyd said the budget impact analysis methods used in the study can project the future impact of implementing a novel treatment on healthcare spending. The open source decision model developed by the Monash University team is available to any health service, allowing the input of local data to customise the results to their setting.

“Whilst our study focuses on Australia, the open-source model designed for the study can be used by other jurisdictions and health services to explore cost implications of implementation within their patient population,” said Dr Lloyd.

“Our hope is that the findings from our study will help to inform health policy in this space, in a way that offers women tangible support to achieve the healthiest outcomes for themselves and their babies.”

The full article, entitled Projected Return on Investment From Implementation of a Lifestyle Intervention to Reduce Adverse Pregnancy Outcomes is published in the medical journal JAMA Network Open, which is published by the American Medical Association.

Period7 Sept 2022

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