Background: Reducing stillbirth rates is an international priority; however, little is known about the cost of stillbirth. This analysis sought to quantify the costs of stillbirth in Australia. Methods: Mothers and costs were identified by linking a state-based registry of all births between 2012 and 2015 to other administrative data sets. Costs from time of birth to 2 years postbirth were included. Propensity score matching was used to account for differences between women who had a stillbirth and those that did not.Macroeconomic costs were estimated using value of lost output analysis and value of lost welfare analysis. Results: Cost to government was on average $3774 more per mother who had a stillbirth compared with mothers who had a live birth. After accounting for gestation at birth, the cost of a stillbirth was 42% more than a live birth (P < .001). Costs for inpatient services, emergency department services, services covered underMedicare (such as primary and specialist care, diagnostic tests and imaging), and prescription pharmaceuticals were all significantly higher for mothers who had a stillbirth. Mothers who had a stillbirth paid on average $1479 out of pocket, which was 52% more than mothers who had a live birth after accounting for gestation at birth (P < .001). The value of lost output was estimated to be $73.8 million (95% CI: 44.0 million-103.9 million). The estimated value of lost social welfare was estimated to be $18 billion. Discussion: Stillbirth has a sustained economic impact on society and families, which demonstrates the potential resource savings that could be generated from stillbirth prevention.
The valuation of ecosystem services to inform natural resource management and development has gained acceptance in many arenas. Yet, contemporary economic valuation is constrained to the appraisal of simple goods that generate benefits that accrue to individuals, neglecting complex goods that generate benefits that accrue to society more broadly. Methodological barriers to the valuation of complex social goods have led to their frequent omission from natural resource management deliberations. The prevailing valuation paradigm that focuses on simple individual goods may erode conservation efforts by crowding out the institutions and behaviours that support socially constructed ecosystem service values. Erosion of these values ultimately harms the environment and society as a whole. The institutionalisation of appropriate methods for estimating the value of complex social goods alongside existing methods for valuing simple individual goods within international conservation, development and policy-making discourses, is therefore an important evolution for sustainable natural resource management.
Flexible learning options (FLOs) provide individualised learning pathways for disengaged young people with strong emphasis on inclusivity and wellbeing support. Amidst a rapid expansion of Australia's flexible learning sector, service providers are under increasing pressure to substantiate participant outcomes. This paper stems from a national study of the value of FLOs to young people and the broader Australian community. The study enumerates the outcomes valued by flexible learning practitioners, as well as the various evidence forms they cite to substantiate participant outcomes. Framing success as 'distance travelled' (i.e., an individual's progress relative to his or her own starting point), practitioners demonstrate critical awareness of the social and structural mechanisms by which young people are marginalised from mainstream schooling. Holistic assessment practices also reveal practitioners' efforts to expand the terms of reference by which educational outcomes may be validated in alternative education settings.
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