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Eur J Obstet Gynecol Reprod Biol. 2017 Sep;216:130-137. doi: 10.1016/j.ejogrb.2017.07.027. Epub 2017 Jul 23.

Cost-effectiveness of simulation-based team training in obstetric emergencies (TOSTI study).

Author information

1
Department of Obstetrics and Gynaecology, Elkerliek Hospital, Helmond, The Netherlands. Electronic address: j.vandeven@elkerliek.nl.
2
Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
3
Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
4
Department of Obstetrics and Gynaecology, Máxima Medical Center, Eindhoven, Veldhoven, The Netherlands.
5
The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, and The South Australian Health and Medical Research Institute, Adelaide, Australia.
6
Department of Obstetrics and Gynaecology, Máxima Medical Center, Eindhoven, Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.

Abstract

OBJECTIVE:

Team training is frequently applied in obstetrics. We aimed to evaluate the cost-effectiveness of obstetric multi-professional team training in a medical simulation centre.

STUDY DESIGN:

We performed a model-based cost-effectiveness analysis to evaluate four strategies for obstetric team training from a hospital perspective (no training, training without on-site repetition and training with 6 month or 3-6-9 month repetition). Data were retrieved from the TOSTI study, a randomised controlled trial evaluating team training in a medical simulation centre. We calculated the incremental cost-effectiveness ratio (ICER), which represent the costs to prevent the adverse outcome, here (1) the composite outcome of obstetric complications and (2) specifically neonatal trauma due to shoulder dystocia.

RESULTS:

Mean costs of a one-day multi-professional team training in a medical simulation centre were €25,546 to train all personnel of one hospital. A single training in a medical simulation centre was less effective and more costly compared to strategies that included repetition training. Compared to no training, the ICERs to prevent a composite outcome of obstetric complications were €3432 for a single repetition training course on-site six months after the initial training and €5115 for a three monthly repetition training course on-site after the initial training during one year. When we considered neonatal trauma due to shoulder dystocia, a three monthly repetition training course on-site after the initial training had an ICER of €22,878.

CONCLUSION:

Multi-professional team training in a medical simulation centre is cost-effective in a scenario where repetition training sessions are performed on-site.

KEYWORDS:

Cost-effectiveness; Obstetric care; Randomised controlled trial; Simulation; Team training

PMID:
28763738
DOI:
10.1016/j.ejogrb.2017.07.027
[Indexed for MEDLINE]

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