Cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean for normal risk pregnant women in the Brazilian Unified National Health System

Cadernos de saúde pública
Aline Piovezan EntringerMaria Auxiliadora de Souza Mendes Gomes

Abstract

The purpose of this study was to conduct a cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean (with no clinical indication) for normal risk pregnant women, from the perspective of the Brazilian Unified National Health System. An analytical decision model was developed and included the choice of delivery mode and clinical consequences for mothers and newborns, from admission for delivery to hospital discharge. The reference population consisted of normal risk pregnant women with singleton, at-term gestations in cephalic position, subdivided into primiparas and multiparas with prior uterine scar. Cost data were obtained from three public maternity hospitals (two in Rio de Janeiro, one in Belo Horizonte, Minas Gerais State, Brazil). Direct costs were identified with human resources, hospital inputs, and capital and administrative costs. Effectiveness measures were identified, based on the scientific literature. The study showed that vaginal delivery was more efficient for primiparas, at lower cost (BRL 1,709.58; USD 518.05) than cesarean (BRL 2,245.86; USD 680.56) and greater effectiveness for three of the four target outcomes. For multiparas with prior uterine scar, repeat cesarean was cost-effectiv...Continue Reading

References

Aug 18, 2004·Revista de saúde pública·Aníbal FaúndesMaria Helena de Sousa
Jan 27, 2005·American Journal of Obstetrics and Gynecology·Bryan S RichardsonRenato Natale
Feb 14, 2007·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Shiliang LiuUNKNOWN Maternal Health Study Group of the Canadian Perinatal Surveillance System
Nov 6, 2007·BMJ : British Medical Journal·José VillarUNKNOWN World Health Organization 2005 Global Survey on Maternal and Perinatal Health Research Group
Jul 7, 2009·Cadernos de saúde pública·Natália Ribeiro MandarinoJosé Albuquerque de Figueiredo Neto
Oct 9, 2009·Journal of Perinatology : Official Journal of the California Perinatal Association·E J GellerA G Visco
Nov 28, 2009·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Leanne S DahlgrenRobert M Liston
Mar 18, 2010·American Journal of Perinatology·Elizabeth J GellerAnthony G Visco
Apr 24, 2010·Ciência & saúde coletiva·Priscila Oliveira CardosoAndy Petroianu
Aug 19, 2011·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Christina LarssonEllika Andolf
Mar 30, 2012·The American Journal of Clinical Nutrition·Emily PriorMatthew J Hyde
Aug 18, 2012·Acta Obstetricia Et Gynecologica Scandinavica·Cheryl ChongArijit Biswas
Mar 9, 2013·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Sherrie KellyMark Walker
Sep 18, 2013·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Sharon A GilbertUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Aug 29, 2014·Cadernos de saúde pública·Rosa Maria Soares Madeira DominguesMaria do Carmo Leal
Aug 29, 2014·Cadernos de saúde pública·Marcos Augusto Bastos DiasMaria do Carmo Leal
Aug 29, 2014·Cadernos de saúde pública·Antônio Augusto Moura da SilvaMaria do Carmo Leal
Aug 29, 2014·Cadernos de saúde pública·Maria A S Mendes Gomes
Oct 22, 2016·Reproductive Health·Marcos Nakamura-PereiraMaria Elisabeth Moreira
Nov 1, 2001·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·M J D OsisA Faúndes
Jun 24, 2018·Value in Health Regional Issues·Gustavo L A de OliveiraFrancisco A Acurcio

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.