Cost measurement and valuation of resource use
The primary outcome of EmCS occurred in 107/482 (22.2%) of the CTG+STan arm and in 107/485 (22.1%) in the CTG alone arm, adjusted relative risk (RR) 1.02; 95% confidence interval (0.81 to 1.27), P=0.89 (1). In addition to observing the primary outcome, data from various clinical feeder systems were used to identify the level of care provided and the subsequent resource inputs for each patient. All inpatient costs were calculated on a full absorption basis (i.e. inclusion of direct and indirect costs) for each type of resource used. The preparation of costing data conformed to standards required for the National Hospital Cost Data Collection for the year of collection. This was done with the exception of two cases where known neonatal admission cost data were missing. After investigation, this missingness was assumed to be at random and costs were imputed based in average neonatal admission costs for that arm. All costs are expressed in Australian dollars (AUD) for the financial year (FY) 2021. Costs from the FY2018 are inflated 8.3503%; FY2019, 6.1453%; and FY2020, 3.6229%, based on the inflation of the National Efficient Price (NEP) for health care services provided by public hospitals, as determined by the The Independent Hospital Pricing Authority (IHPA) (12).
The analysis used a health service perspective and included episode costs for all maternal and neonatal admissions and readmissions that occurred within a six week window from randomization.