Rogers R G, Gardner M O, Tool K J, Ainsley J, Gilson G
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque 87131, USA.
West J Med. 2000 Apr;172(4):240-3. doi: 10.1136/ewjm.172.4.240.
To compare the costs of a protocol of active management of labor with those of traditional labor management.
Cost analysis of a randomized controlled trial.
From August 1992 to April 1996, we randomly allocated 405 women whose infants were delivered at the University of New Mexico Health Sciences Center, Albuquerque, to an active management of labor protocol that had substantially reduced the duration of labor or a control protocol. We calculated the average cost for each delivery, using both actual costs and charges.
The average cost for women assigned to the active management protocol was $2,480.79 compared with an average cost of $2,528.61 for women in the control group (P = 0.55). For women whose infant was delivered by cesarean section, the average cost was $4,771.54 for active management of labor and $4,468.89 for the control protocol (P = 0.16). Spontaneous vaginal deliveries cost an average of $27.00 more for actively managed patients compared with the cost for the control protocol.
The reduced duration of labor by active management did not translate into significant cost savings. Overall, an average cost saving of only $47.91, or 2%, was achieved for labors that were actively managed. This reduction in cost was due to a decrease in the rate of cesarean sections in women whose labor was actively managed and not to a decreased duration of labor.
比较积极产程管理方案与传统产程管理的成本。
随机对照试验的成本分析。
1992年8月至1996年4月，我们将405名在阿尔伯克基新墨西哥大学健康科学中心分娩的妇女随机分配至显著缩短产程的积极产程管理方案组或对照组。我们使用实际成本和收费计算每次分娩的平均成本。
分配至积极管理方案组的妇女平均成本为2480.79美元，而对照组妇女平均成本为2528.61美元（P = 0.55）。对于剖宫产分娩的妇女，积极产程管理的平均成本为4771.54美元，对照组方案为4468.89美元（P = 0.16）。与对照组方案相比，积极管理的患者自然阴道分娩平均多花费27.00美元。
积极管理缩短产程并未转化为显著的成本节约。总体而言，积极管理的产程平均仅节约成本47.91美元，即2%。成本降低是由于积极管理产程的妇女剖宫产率降低，而非产程持续时间缩短。
