Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
Cost-effectiveness of a preventive counseling and support package for postnatal depression.
OBJECTIVES This study reports the cost-effectiveness of a preventive intervention , consisting of counseling and specific support for the mother-infant relationship , targeted at women at high risk of developing postnatal depression . METHODS A prospect i ve economic evaluation was conducted alongside a pragmatic r and omized controlled trial in which women considered at high risk of developing postnatal depression were allocated r and omly to the preventive intervention ( n = 74 ) or to routine primary care ( n = 77 ) . The primary outcome measure was the duration of postnatal depression experienced during the first 18 months postpartum . Data on health and social care use by women and their infants up to 18 months postpartum were collected , using a combination of prospect i ve diaries and face-to-face interviews , and then were combined with unit costs ( pound , year 2000 prices ) to obtain a net cost per mother-infant dyad . The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness to pay thresholds held by decision makers for preventing 1 month of postnatal depression . RESULTS Women in the preventive intervention group were depressed for an average of 2.21 months ( 9.57 weeks ) during the study period , whereas women in the routine primary care group were depressed for an average of 2.70 months ( 11.71 weeks ) . The mean health and social care costs were estimated at pounds sterling 2,396.9 per mother-infant dyad in the preventive intervention group and pounds sterling 2,277.5 per mother-infant dyad in the routine primary care group , providing a mean cost difference of pounds sterling 119.5 ( bootstrap 95 percent confidence interval [ CI ] , -535.4 , 784.9 ) . At a willingness to pay threshold of pounds sterling 1,000 per month of postnatal depression avoided , the probability that the preventive intervention is cost-effective is .71 and the mean net benefit is pounds sterling 383.4 ( bootstrap 95 percent CI , - pounds sterling 863.3- pounds sterling 1,581.5 ) . CONCLUSIONS The preventive intervention is likely to be cost-effective even at relatively low willingness to pay thresholds for preventing 1 month of postnatal depression during the first 18 months postpartum . Given the negative impact of postnatal depression on later child development , further research is required that investigates the longer-term cost-effectiveness of the preventive intervention in high risk women
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .