What are the costs of stillbirth? Capturing the direct health care and macroeconomic costs in Australia

Abstract

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.

Prospective cohort study: Causes of stillbirth in Australia 2013–2018

“…This seems a reasonable cost to the health system given the value of information produced from the investigations for many diagnoses as well as informing prevention or changes in management for subsequent pregnancies. Furthermore, the broader societal cost of stillbirths (healthcare costs and lost productivity) incurred by the government is an additional $3774 per pregnancy ending in stillbirth 30 . Adhering to stillbirth investigations recommended by the new PSANZ guidelines has the potential to optimise resource use and provide critical knowledge for planning future prevention programs.…”

Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Safer Baby Bundle study protocol

“…The intervention costs will be obtained from the routinely collected health service utilisation data. In addition, health service and societal costs of stillbirth will be captured using publicly available data sources or data from peer-reviewed publications for women who have a stillbirth and those who do not, developed as a part of the Stillbirth CRE [1]. In partnership with the Stillbirth CRE the economic evaluation is being conducted by Dr Emily Callander from Monash University.…”

“…Stillbirth is a tragic event for the woman, her partner, family and friends, as well as the healthcare professionals involved. Stillbirth imparts significant costs across the health system and society [1]. Every day in Australia six babies are stillborn, amounting to more than 2000 deaths a year [2].…”

Making every birth count: Outcomes of a perinatal mortality audit program

“…Perinatal death (stillbirth and neonatal death) is a devastating event affecting at least five million families globally each year 1 . In Australia, stillbirth accounts for 70% of perinatal deaths and remains a serious public health problem with far‐reaching psychosocial and economic consequences 2 . There has been little change in stillbirth rates in Australia, overall, over the past three decades.…”