| Backgrounds and Objective:With the economic and social development,fertility decline,pregnancy complications have become worldwide medical problems of affectting the number and quality of birth population.As a key barrier to primary prevention and intervention for infertility and adverse pregnancy outcomes,pre-pregnancy health care aimed to provide health promotion and preventive health services for women of childbearing age.In the pre-pregnancy period of pregnant women,we should take the initiative to eliminate the risk factors of pregnancy,so that each couple could be in good condition to nurture the fetus,improve the pregnancy rate,reduce pregnancy complications and prevent birth defects.The current pre-pregnancy health care models focused on medical examination,while the traditional Chinese medicine(TCM)prevention treatment of disease have not yet been carried out for women of childbearing age.We will carry out the application of TCM prevention and health care service packageage in Jiaozuo and Xinxiang of Henan Province,and evaluate the cost-effectiveness of the health services.Providing policy advice for the application of TCM preventive treatment of diseases among women who prepare to get pregnant and exploring a new model of pre-pregnancy health services in China.Subjects and MethodsSeven districts and counties in Henan province were selected by cluster randomized sampling method,and 806 women who were prepared to get pregnant were included in this study between December 2015 and January 2016.For intervention group,beside conventional eugenic guidance,the intervention group were also applied by TCM service pack.For control group,only conventional eugenics health guidance was used for women of childbearing age.The pregnancy rate of women and the life quality score were evaluated after 3 and 6 months.The costs of the intervention group and the control group were calculated using the cost estimation method.Economic evaluation was made by calculating the cost-effectiveness ratio.ResultsThe pregnancy rates of intervenient group and control group after 3 months was 23.1%and 14.1%,separately(P=0.0059).After 6 months,the pregnancy rates of two groups were 35.8%and 23.8%,separately(P=0.0014).At the same time,for older women(age>35 years),the pregnancy rates of the intervention group were 19.9%and 32.7%in the third and sixth months,which were significantly better than those in the the control group.The quality of life scores of women without pregnancy were found to have improved after intervention for 6 months.Besides,the cost for each woman was 138.04 yuan in the intervention group and 127.48 yuan in the control group.The cost of each successful pregnant women was 385.46 yuan in the intervention group and 534.90 yuan in the control group.The health services package of TCM preventive treatment of disease has a better cost effectiveness ratio.After sensitivity analysis,the result of this study remained stable when employees' salaries fluctuated in normal range.In the women with different ages and different levels of education,the intervention group had a better cost-effectiveness ratio compared with the control group.The more frequently women used the service package,the higher the pregnancy rate was.Probability sensitivity analysis found that,Cost-effectiveness threshold of Cost-effectiveness Acceptability Curve was significantly less than 1 times GDP.It shows that the the health services package of TCM preventive treatment of disease is a high cost-effectiveness strategy.ConclusionsHealth services package of TCM preventive treatment of disease has a better effectiveness in improving fertility of women than conventional health education,and the cost-effectiveness of the intervention is better than control group. |
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