Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Birth. 2013 Dec;40(4):221-6. doi: 10.1111/birt.12062.
Hospital practices supportive of breastfeeding can improve breastfeeding rates. There are limited data available on how improved hospital practices are associated with hospital costs. We describe the association between the number of breastfeeding supportive practices a hospital has in place and the cost of an uncomplicated birth.
Data from hospitals in 20 states that participated in the 2007 Maternity Practices in Infant Nutrition and Care (mPINC) survey and Healthcare Cost and Utilization Project's (HCUP) State Inpatient Databases (SID) were merged to calculate the average median hospital cost of uncomplicated vaginal and cesarean section births by number of ideal practices from the Ten Steps to Successful Breastfeeding. Linear regression analyses were conducted to estimate change in birth cost for each additional ideal practice in place.
Sixty-one percent of hospitals had ideal practice on 3-5 of the 10 steps, whereas 29 percent of hospitals had ideal practice on 6-8. Adjusted analyses of uncomplicated births revealed a higher but nonsignificant increase in any of the birth categories (all births, $19; vaginal, $15; cesarean section, $39) with each additional breastfeeding supportive maternity care practice in place.
Our results revealed that the number of breastfeeding supportive practices a hospital has in place is not significantly associated with higher birth costs. Concern for higher birth costs should not be a barrier for improving maternity care practices that support women who choose to breastfeed.
支持母乳喂养的医院实践可以提高母乳喂养率。关于改进的医院实践如何与医院成本相关联,可用的数据有限。我们描述了医院实施的母乳喂养支持实践的数量与简单分娩成本之间的关联。
合并了来自参与 2007 年母婴营养与护理实践(mPINC)调查和医疗保健成本和利用项目(HCUP)州住院数据库(SID)的 20 个州的医院数据,以计算 10 个成功母乳喂养步骤中每增加一个理想实践的无并发症阴道分娩和剖宫产的平均中位数医院成本。进行线性回归分析,以估计每个额外理想实践的出生成本变化。
61%的医院在 10 个步骤中的 3-5 个步骤中有理想的实践,而 29%的医院在 6-8 个步骤中有理想的实践。对无并发症分娩的调整分析显示,任何一种分娩类别(所有分娩、$19;阴道分娩、$15;剖宫产、$39)的分娩成本都有较高但无统计学意义的增加,每增加一个支持母乳喂养的产妇护理实践。
我们的结果表明,医院实施的母乳喂养支持实践的数量与较高的分娩成本没有显著关联。对于提高支持选择母乳喂养的妇女的产妇护理实践,不应担心更高的分娩成本。