Chapple Will, Gilliland Amy, Li Dongmei, Shier Emily, Wright Emily
University of Wisconsin School of Medicine and Public Health, Health Sciences Learning Center, Student Services Office, 750 Highland Ave, Madison, WI 53705-2266, USA.
WMJ. 2013 Apr;112(2):58-64.
The purpose of this study is to estimate the immediate cost savings per delivery with in-hospital professional doula labor support in Wisconsin. This is the first study that calculates the estimated cost savings of professional doula labor support specific to Wisconsin.
This analysis used results presented in and derived from the Cochrane Review of continuous labor support to estimate procedure reduction and cost savings in Wisconsin using birth statistics from 2010. The delivery outcomes included were cesarean deliveries, instrumental deliveries, and regional analgesia use. To accurately reflect published studies on labor support, only low-risk deliveries were used for intervention reduction calculations.
For 2010 data, estimated savings of 28,997,754.80 dollars could have been achieved if every low-risk birth were attended in-hospital by a professional doula. A professional doula providing only in-hospital labor support would yield an estimated cost savings of 424.14 dollars per delivery or 530.89 dollars per low-risk delivery.
A system-based change in how laboring mothers are supported would be an innovative step that would put Wisconsin at the forefront of cost-effective health care, reducing interventions while improving outcomes. It is recommended that Wisconsin insurers consider reimbursing for professional doula labor support. It is also recommended that pilot programs be implemented in Wisconsin that can better assess the implementation of professional doula labor support services.
本研究的目的是估算在威斯康星州，由医院专业导乐提供分娩支持时每次分娩可立即节省的成本。这是第一项计算威斯康星州专业导乐分娩支持估计成本节约情况的研究。
本分析使用了Cochrane持续性分娩支持综述中的结果并由此推导，利用2010年的出生统计数据来估算威斯康星州分娩程序减少情况及成本节约情况。纳入的分娩结局包括剖宫产、器械助产和区域镇痛的使用。为准确反映关于分娩支持的已发表研究，仅将低风险分娩用于干预减少情况的计算。
对于2010年的数据，如果每例低风险分娩都有专业导乐在医院陪伴，估计可节省28,997,754.80美元。仅提供医院分娩支持的专业导乐预计每次分娩可节省成本424.14美元，或每例低风险分娩节省530.89美元。
在如何支持分娩母亲方面进行基于系统的变革将是创新之举，能使威斯康星州在具有成本效益的医疗保健领域处于前沿，减少干预措施同时改善分娩结局。建议威斯康星州的保险公司考虑为专业导乐分娩支持提供报销。还建议在威斯康星州实施试点项目，以便能更好地评估专业导乐分娩支持服务的实施情况。
