Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway

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dc.contributor.advisorCleary, Susanen_ZA
dc.contributor.authorMovik, Espenen_ZA
dc.date.accessioned2014-11-08T14:30:45Z
dc.date.available2014-11-08T14:30:45Z
dc.date.issued2010en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractFollowing recommendations laid down by a consensus conference in 1986, the policy of the Norwegian government has been to offer a routine ultrasound scan to all pregnant women at 18 weeks of gestation, i.e. in the second trimester (weeks 14-27) of pregnancy . This form of antenatal screening is also provided in other European countries, though several countries have gone further and now offer universal screening in the first trimester (weeks 1-13), between the 11th and 13th week of gestation, as well as in the second. In 2006, the Norwegian Directorate for Health contemplated a revision of its antenatal care guidelines, and in the process, sought to determine whether anexpansion of the programme to incorporate universal first trimester screening would be a rational step with regard to the anticipated extra benefits and costs. Except for a relatively small patient co-payment charge, antenatal screening is publicly financed as is the case with most other healthservices. Norway has however, a small but thriving private healthcare sector, and first trimester ultrasound scanning has been offered by private providers in recent years. The are many potential benefits of antenatal ultrasound screening and some of them are undoubtedly controversial. The information gained from a scan may, depending on its timing, assist in determining the pregnancy term, the number of foetuses in the uterus, the location of the placenta and the condition of the foetus. If the foetus is found to suffer from a particular disease, it may sometimes be treated prior to birth. Invariably however, ultrasound scanning in pregnancy is often associated with the detection of foetal anomalies or defects, such as Down syndrome, congenital heart defects or neural tube defects. The detection can in some cases lead to the pregnancy being terminated, whilst in other cases it may prepare the parents for a life with a child who may requiremore attention and care than others. This provision of information may be considered beneficial, however one may choose to act upon it, although it also invites an active decision which could induce negative feelings. On the other hand, the potential stress and anxiety involved in the screening and diagnostic process may be viewed as disadvantageous. This study will focus on two of the most important anomalies, at least in terms of the attention they are given in the literature: Down syndrome (DS) and serious congenital heart defects (SCHD).en_ZA
dc.identifier.apacitationMovik, E. (2010). <i>Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/9398en_ZA
dc.identifier.chicagocitationMovik, Espen. <i>"Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2010. http://hdl.handle.net/11427/9398en_ZA
dc.identifier.citationMovik, E. 2010. Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Movik, Espen AB - Following recommendations laid down by a consensus conference in 1986, the policy of the Norwegian government has been to offer a routine ultrasound scan to all pregnant women at 18 weeks of gestation, i.e. in the second trimester (weeks 14-27) of pregnancy . This form of antenatal screening is also provided in other European countries, though several countries have gone further and now offer universal screening in the first trimester (weeks 1-13), between the 11th and 13th week of gestation, as well as in the second. In 2006, the Norwegian Directorate for Health contemplated a revision of its antenatal care guidelines, and in the process, sought to determine whether anexpansion of the programme to incorporate universal first trimester screening would be a rational step with regard to the anticipated extra benefits and costs. Except for a relatively small patient co-payment charge, antenatal screening is publicly financed as is the case with most other healthservices. Norway has however, a small but thriving private healthcare sector, and first trimester ultrasound scanning has been offered by private providers in recent years. The are many potential benefits of antenatal ultrasound screening and some of them are undoubtedly controversial. The information gained from a scan may, depending on its timing, assist in determining the pregnancy term, the number of foetuses in the uterus, the location of the placenta and the condition of the foetus. If the foetus is found to suffer from a particular disease, it may sometimes be treated prior to birth. Invariably however, ultrasound scanning in pregnancy is often associated with the detection of foetal anomalies or defects, such as Down syndrome, congenital heart defects or neural tube defects. The detection can in some cases lead to the pregnancy being terminated, whilst in other cases it may prepare the parents for a life with a child who may requiremore attention and care than others. This provision of information may be considered beneficial, however one may choose to act upon it, although it also invites an active decision which could induce negative feelings. On the other hand, the potential stress and anxiety involved in the screening and diagnostic process may be viewed as disadvantageous. This study will focus on two of the most important anomalies, at least in terms of the attention they are given in the literature: Down syndrome (DS) and serious congenital heart defects (SCHD). DA - 2010 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway TI - Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway UR - http://hdl.handle.net/11427/9398 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9398
dc.identifier.vancouvercitationMovik E. Economic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norway. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2010 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9398en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHealth Economics Tracken_ZA
dc.titleEconomic evaluation of antenatal screening for Down Syndrome and serious congenital heart defects in Norwayen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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