Abstract
Objectives
The increased integration of digital health into maternity care—alongside growing
use of, and access to, personal digital technology among pregnant women—warrants an
investigation of the cost-effectiveness of mHealth interventions used by women during
pregnancy and the methodological quality of the cost-effectiveness studies.
Methods
A systematic search was conducted to identify peer-reviewed studies published in the
last ten years (2011–2021) reporting on the costs or cost-effectiveness of mHealth
interventions used by women during pregnancy. Available data related to program costs,
total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported
in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed
using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).
Findings
Nine articles reporting on eight studies met the inclusion criteria. Direct intervention
costs ranged from $7.04 to $86 per woman, total program costs ranged from $241,341
to $331,136 and total incremental costs ranged from -$21.16 to $1.12 million per woman.
The following ICERs were reported: $2168 per DALY averted, $203.44 per woman ceasing
smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were
moderate to high in quality and all reported the mHealth intervention as cost-effective.
Other studies (n = 4) were low to moderate in quality and reported low costs or cost
savings associated with the implementation of the mHealth intervention.
Conclusions for practice
Preliminary evidence suggests mHealth interventions may be cost-effective and “low-cost”
but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions
regarding positive maternal and child health outcomes and longer-term health service
utilisation.
Abbreviations:
ICER (Incremental Cost-Effectiveness Ratio), CHEERS (Consolidated Health Economic Evaluation Reporting Standards), DALY (Disability Adjusted Life Year), QALY (Quality Adjusted Life Year), SMS (Short Message Service), ICT (Information and Communication Technology), NHS (National Health Service), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), USD (United States Dollar), LMIC (Low-to-Middle-Income Country)Keywords
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Article info
Publication history
Published online: March 23, 2022
Accepted:
March 16,
2022
Received in revised form:
March 14,
2022
Received:
December 16,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
