115 Budget impact analysis of aCTG in primary midwife-led care Table 3: Budget impact results according to different implementation rates of MLC-aCTG Analysis, n MLC-aCTG implementation rates Actual costs Reimbursed costs Budget impact: actual costs (95% CI) Budget impact: reimbursement (95% CI) Base-case analysis, n= 28,597 Reference: 0% (i.e., 100% OLC-aCTG) € 6,717,139 € 42,666,047 25% € 7,028,902 € 35,127,711 € 311,763 (€ 188,574; € 426,072) -€ 7,538,335 (-€ 10,302,306; -€4,559,661) 50% € 7,340,665 € 27,589,376 € 623,526 (€ 377,148; 852,145) -€ 15,076,671 (- € 20,604,613; -€ 9,119,322) 75% € 7,652,428 € 20,051,040 € 935,289 (€ 565,722; €1,278,217) -€ 22,615,006 (-€ 30,906,919; -€ 13,678,984) 100% € 7,964,191 € 12,512,705 € 1,247,052 (€ 754,296; € 1,704,290) -€ 30,153,342 (-€ 41,209,225; -€ 18,238,645) Sensitivity analysis, n= 21,375 Reference: 0% (i.e., 100% OLC-aCTG) € 5,020,892 € 31,891,792 25% € 5,253,927 € 26,257,077 € 233,035 (€ 149,260; € 372,683) -€ 5,634,715 (-€ 9,011,368; -€ 3,609,068) 50% € 5,486,962 € 20,622,362 € 466,070 (€ 298,520; € 745,366) -€ 11,269,431 (-€ 18,022,736; -€ 7,218,136) 75% € 5,719,997 € 14,987,646 € 699,105 (€ 447,781, € 1,118,049) -€ 16,904,146 (-€ 27,034,104; -€ 10,827,204) 100% € 5,953,032 € 9,352,931 € 932,140 (€ 597,041; € 1,490,733) -€ 22,538,862 (-€ 36,045,473; -€ 14,436,272) n: estimated number of aCTGs in 2022. MLC-aCTG: midwife-led care antenatal cardiotocograph. OLC-aCTG: obstetrician-led care antenatal cardiotocograph Base-case analysis was based on the prevalence of performing an aCTG with three indications (19.8%) Sensitivity analysis was based on the prevalence of performing an aCTG with one indication, i.e., reduced fetal movements (14.8%) Costs are indexed to 2020. 95% CI = confidence interval 5
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