Guideline adherence is worth the effort: a cost-effectiveness analysis in intrauterine insemination care.

Study Question: Is optimal adherence to guideline recommendations in intrauterine insemination (IUI) care cost-effective from a societal perspective when compared with suboptimal adherence to guideline recommendations?

Summary Answer: Optimal guideline adherence in IUI care has substantial economic benefits when compared with suboptimal guideline adherence.

What Is Known Already: Fertility guidelines are tools to help health-care professionals, and patients make better decisions about clinically effective, safe and cost-effective care. Up to now, there has been limited published evidence about the association between guideline adherence and cost-effectiveness in fertility care.

Patient and hospital characteristics associated with variation in guideline adherence in intrauterine insemination care.

Objective: To assess the association of patient and hospital characteristics with adherence to guidelines for intrauterine insemination (IUI) care.

Design: Retrospective cohort study using multilevel regression analysis. Characteristics studied at the patient level were female age, type and duration of subfertility, diagnosis and number of started IUI cycles.

Variation in guideline adherence in intrauterine insemination care.

Health-care delivery according to clinical practice guidelines is thought to be critical in achieving optimal outcomes. This study aimed to assess the extent to which practice performance in intrauterine insemination (IUI) care is consistent with guideline recommendations and to evaluate the association between guideline adherence and outcome of IUI care. In a retrospective cohort study, 1100 infertile couples who underwent IUI treatment at 10 Dutch hospitals were asked to grant access to their medical record for assessment of guideline adherence using 25 systematically developed guideline-based performance indicators.

Subfertile couples' negative experiences with intrauterine insemination care.

Objective: To identify subfertile couples' experiences with specific aspects of intrauterine insemination (IUI) care and to determine which patient and hospital characteristics affect their experiences.

Design: Cross-sectional survey with written questionnaires.

Setting: One large tertiary hospital and nine medium-sized hospitals, including both teaching and nonteaching centers, in the southeast of the Netherlands.

Monitoring reproductive health in Europe: what are the best indicators of reproductive health? A need for evidence-based quality indicators of reproductive health care.

Monitoring reproductive health by the Reprostat indicators in Europe will facilitate the transparency of reproductive health as well as comparisons over time and between countries. However, for the monitoring and improvement of reproductive health care, we suggest the systematic development of evidence-based quality indicators, especially process and structure indicators.