Maternal And Child Health APP Promotes The Knowledge Of Health Care During Pregnancy And Service Utilization Of Cost-effectiveness Analysis

Objective By comparing mother-child health APP with traditional media health education and publicity methods,the cost effect of mother-child health APP in knowledge knowledge and service utilization is understood,so as to provide theoretical basis for the further promotion of mother-child health APP and the development of targeted health education channels.Methods In this study,two counties in central Henan and western Xinjiang Uygur Autonomous Region were selected as the study sites in the pilot provinces of the mother-child health APP promotion and application project supported by the Information Department of Maternal and Child Health Center of the Chinese Center for Disease Control and Prevention with the support of UNICEF.A survey was conducted on the transformation,use and promotion of maternal and child health APP in 71 medical institutions in the study site,and a descriptive analysis was conducted on the implementation effect of the basic situation.The count data were described by frequency(rate).The 344 pregnant women in early pregnancy(≤13 weeks)who met the inclusion criteria were selected as the control group and the pregnant women in the selection cohort who did not insist on using the maternal and child health APP(not downloaded,used infrequently or unloaded)as the intervention group.Prospective,nested case-control retrospective study method is used to carry on the mother and child health APP after the intervention in promoting knowledge about prenatal care and service utilization research,qualitative data using group discussion and individual in-depth interviews descriptive analysis,the quantitative data of intervention group and control group rate changes compared using the chi-square test,analyses effect between groups through times difference method.Combined with development operations and estimate the cost of the medical institutions baseline survey results,from the perspective of knowledge about pregnancy and service utilization,cycle for 1 year,from two dimensions of cost and effect evaluation of 1 year compared with the traditional way of health education intervention of medical institutions,the cost and effect of APP mother and child health interventions,and calculate the incremental cost-effectiveness ratio(ICER),At the same time,the single factor sensitivity analysis was used to clarify the impact of cost reduction on the results.Results1.Implementation effect:46.0%of the medical institutions added the application function of maternal and child health APP,32.2%of the medical institutions introduced the maternal and child health education content of the APP,and built the maternal and child health information platform through the information interconnection platform of the maternal and child health APP,accounting for 44.8%.85.9%of medical institutions publicize and use mother-child health APPs.The utilization rate of APP in Xinjiang(94.4%)is higher than that in Henan(77.1%).The department of health care is mainly responsible for the publicity,accounting for 21.1%.Low recognition of service objects(31.4%)is the main reason for not promoting the use of maternal and child health APP.The mother-and-child health APP has a positive impact on the work efficiency of medical staff,and the current content and presentation form are basically satisfied.Pregnant women downloaded and used maternal and child health apps for 47.2%,and users who downloaded maternal and child health apps and read health education content accounted for 100%.After the intervention,the satisfaction rate increased from 30.9%to 53.6%.Through the comparison of the growth rate of knowledge awareness between the intervention group and the control group,it was found that the growth rate of maternal and child health APP in the intervention group was higher than that in the control group(P<0.05).The net effect of the intervention increased the knowledge awareness rate during pregnancy by 1.806 times(2.502～14.797).Comprehensive analysis showed that maternal and child health APP intervention increased the possibility of knowledge awareness during pregnancy(P<0.05).It was also found by comparison that the growth rate of pregnancy enrollment in the intervention group and the control group was higher than that in the control group(P<0.05).The net effect of the intervention increased the pregnancy enrollment rate in pregnancy by 0.551 times(0.540～5.577),except that pregnant women and their husbands were ethnic minorities.However,the net effect of the intervention was not statistically significant(P<0.05).2.Cost effect:The annual input cost of traditional health education during pregnancy and childbirth in a typical pilot medical institution is estimated at 910,400.00 yuan,and the annual input cost of development and maintenance of maternal and child health APP is estimated at 466,853.00 yuan.(1)Cost-effect of knowledge awareness rate:compared with traditional health education methods,every unit with knowledge awareness rate increased would save 13,948.02 yuan after using mother-child health APP intervention.(2)Cost effect of pregnancy enrollment rate:compared with traditional health education methods,the cost of maternal and child health APP intervention will be saved RMB 27,211.47 for each additional unit of pregnancy enrollment rate.(3)Results of univariate sensitivity analysis:The cost of traditional health education involved in the study was reduced by 20%,and the cost of mother-child health APP was reduced by 40%(the decline rate was assumed according to the actual baseline survey).When other parameters were unchanged,the results showed consistent trends.Therefore,compared with the traditional health education methods,the use of mother-child health APP can play a better intervention effect,and the research conclusion is reliable.Conclusion Therefore,compared with the traditional health education methods,maternal and child health apps have higher effectiveness in the knowledge and behavior norms of pregnant women during pregnancy.Cost-effect analysis confirms that maternal and child health apps have higher cost-effect,and health education based on the new media of maternal and child health apps is a more economic means.Maternal and child health education through new media APP is a more economic means.Therefore,it is necessary to accelerate the promotion of maternal and child health apps and introduce more health education content,complete the construction of information interconnection platform,so that the advantages of professional and safety of maternal and child health apps can be better played,and better pregnancy health management can be carried out under the prevention and control of the epidemic.