GFS Food Security Blog talked with our Postdoctoral Research Fellow Dr Sharmina Ahmed on her current research project with the Centre of Research Excellence (CRE) Food for Future Australians. Dr Ahmed explained about her exciting work on translation of nutrition research into policy and practice change and how findings from this research can benefit Australians and potentially people across the world.
1) Sharmina, what is your current research project and what is your role in that project?
My role in the CRE Food for Future Australians is to collaborate with members of CRE Food for Future Australians on related projects with an aim to effectively translation of nutrition research into policy and practice change.
My responsibilities include analyses and interpretation of primary and secondary data by using modelling and econometric analysis which involves economic evolution and translation, to conduct cost-benefit analysis and to develop survey instruments.
Currently I am working on the cost minimization analysis of a double-blinded, multicentre, randomized controlled trail titled “DHA to Optimized Mother Infant Outcome (DOMInO)”. This trail ran between 2005 and 2011 by Women’s and Children’s Health Research Institute. Women with singleton pregnancies less than 21 weeks’ gestation were included in the trail.
The participants of treatment- group were asked to consume docosahexaeoninc acid (DHA) rich fish oil capsules. The control-group had vegetable oil capsules contained a blend of 3 non-genetically modified oils (rapeseed, sunflower and palm) in equal proportions.
2) Why has a cost-benefit analysis become an important part of your project?
Two of the main outcomes of DOMInO trial were to determine whether DHA rich supplement in pregnancy reduces risk of gestational diabetes mellitus (GDM) or preeclampsia.
Overall, the results of DOMInO trial do not support routine DHA supplementation for pregnant women to reduce GDM or preeclampsia.
However, as secondary outcomes results of DOMInO trial found that maternal DHA supplementation results in small but significant increase in gestation length and birth weight.
This also resulted in a lower number of very pre-term births in the DHA group, but there were more women who were post-term or required inductions.
At this point a cost-minimization analysis becomes important comparing in-hospital total costs of treatment- group with placebo-group.
This approach will be applied based on the facts that, firstly, there was a lack of significant difference in efficacy for primary outcomes and secondly, there are fewer pre term births but more post term birth in the DHA group compared with control group.
Therefore, even though differences in efficacy of the primary outcomes are not statistically significant, the nominal difference may exist when cost analysis taken into account of all the primary and secondary outcomes and that is the objective of this cost analysis.
3) How can your project benefit Australians and whether findings from the project can be relevant for other countries?
In Australia, there are about 17,000 preterm birth babies delivered each year, which are responsible for more than 70% of perinatal mortality.
Keeping a premature baby alive is expensive. The average financial cost for each preterm birth infant is about $3,000 a day in neonatal intensive care. If a baby was born before 26 weeks, the average cost will be about $90,000 per surviving infant.
The same story is also true for all over the world. Every case is different but in US, UK and Australia it is estimated that treating a severely premature baby could cost over $200,000 by the time it leaves hospital.
In an era of financial scrutiny and growing demands for limited healthcare resources both in developed and developing countries, this kind of cost analysis focused on hospital costs would help to develop new strategies for reduction of expenses and facilitate optimum provision of health services.
Only a few studies have evaluated the cost analysis of neonatal intensive care in developed countries. Moreover, there are studies which found noticeable health benefits to the infants and mothers due to DHA intake via supplementation but there are no such cost analysis has been done which emphasis on savings in health care costs.
However, savings in health care costs could be very substantial and such analysis is vital not only for Australia also for other parts of the world.
This cost minimization primarily focused on evaluation of (high) costs for initial maternal hospitalization and associated neonatal intensive care for preterm and post-term infants from a hospital finance perspective. Although significant improvements in treating preterm infants and improving survival have been made, little success in understanding and preventing preterm and post-term birth has been attained all over the world.
Therefore, the research question is whether there is a difference in costs from a societal perspective between DHA supplement group and control group.
For further information, please contact sharmina.ahmed[at]adelaide.edu.au
