• British medical bulletin · Sep 2015

    Review

    Systematic review of the economic evidence on home visitation programmes for vulnerable pregnant women.

    • Eugena Stamuli, Gerry Richardson, Steven Duffy, Michael Robling, and Kerry Hood.
    • York Trials Unit, Department of Health Sciences, University of York, York, UK eugena.stamuli@york.ac.uk.
    • Br. Med. Bull. 2015 Sep 1; 115 (1): 19-44.

    IntroductionA systematic review of the economic evidence on home visitation programmes for young or vulnerable pregnant women was undertaken to provide a summary of the existing literature of these interventions.Sources Of DataRelevant studies were identified from a number of sources including large databases, free text search on Google Scholar as well as hand-searching of the obtained references. The search yielded a large number of papers, of which 12 were considered appropriate to be included in the review. These were either full or partial economic evaluations: four studies were cost-benefit analyses, three were cost-effectiveness analyses and the remaining were costing studies.Areas Of AgreementThe review highlighted the paucity of good quality economic evaluations in the area of home visiting programmes for young or vulnerable pregnant women. Methods varied substantially between the studies spanning from differing data sources (e.g. single randomized trials or meta-analyses) to different perspectives taken, cost items and outcomes included in the analysis.Areas Of ControversyIt is difficult to establish a coherent body of economic evidence for these interventions and draw a firm conclusion on their value for money.Growing PointsHome visiting programmes are complex interventions, with impact on the lives of mothers and their children. The funding of such interventions should be based on rigorous effectiveness and economic evidence.Areas Timely For Developing ResearchThere is a need for well-designed economic evaluations which will follow the appropriate methodological guidelines and also take into account the complexity of such interventions. These analyses should preferably consider multiple perspectives and allow for the fact that the majority of the benefits accrue in the long-term future.© The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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