Garcia-Simon Raquel, Montañes Antonio, Clemente Jesús, Del Pino María D, Romero Manuel A, Fabre Ernesto, Oros Daniel
Obstetrics Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
Faculty of Economics and Business, University of Zaragoza, Spain.
Int J Gynaecol Obstet. 2016 Apr;133(1):112-5. doi: 10.1016/j.ijgo.2015.08.022. Epub 2015 Dec 18.
To assess health service costs associated with labor induction according to different clinical situations in a tertiary-level hospital.
In a prospective study, individual patient cost data were assessed for women admitted for induction of labor at a tertiary hospital in Spain between November 1, 2012, and August 31, 2013. The costs of labor induction were estimated according to maternal and neonatal outcomes, method of delivery, cervical condition at admission, and obstetric indication. Direct costs including professional fees, epidural, maternal stay, consumables, and drugs were calculated.
Overall, 412 women were included in the final cost analysis. The mean total cost of labor induction was €3589.87 (95% confidence interval [CI] 3475.13-3704.61). Cesarean delivery after labor induction (€4830.45, 95% CI 4623.13-5037.58) was significantly more expensive than spontaneous delivery (€3037.45, 95% CI 2966.91-3179.99) and instrumental vaginal delivery (€3344.31, 95%CI 3151.69-3536.93). The total cost for patients with a very unfavorable cervix (Bishop score <2; €4283.47, 95% CI 4063.06-4503.88) was almost double that for women with a favorable cervix (€2605.09, 95% CI 2327.38-2837.58). Labor induction for hypertensive disorders of pregnancy was the most expensive obstetric indication for induction of labor (€4347.32, 95% CI 3890.45-4804.18).
Following the induction of labor, a number of patient- and treatment-related factors influence costs associated with delivery.
在一家三级医院中，根据不同临床情况评估与引产相关的医疗服务成本。
在一项前瞻性研究中，对2012年11月1日至2013年8月31日期间在西班牙一家三级医院因引产入院的女性患者的个体成本数据进行评估。根据母婴结局、分娩方式、入院时宫颈状况和产科指征估算引产成本。计算包括专业费用、硬膜外麻醉、产妇住院时间、耗材和药物在内的直接成本。
总体而言，412名女性被纳入最终成本分析。引产的平均总成本为3589.87欧元（95%置信区间[CI]3475.13 - 3704.61）。引产术后剖宫产（4830.45欧元，95%CI 4623.13 - 5037.58）明显比自然分娩（3037.45欧元，95%CI 2966.91 - 3179.99）和器械助产阴道分娩（3344.31欧元，95%CI 3151.69 - 3536.93）更昂贵。宫颈条件非常不利（Bishop评分<2；4283.47欧元，95%CI 4063.06 - 4503.88）的患者的总成本几乎是宫颈条件有利的女性（2605.09欧元，95%CI 2327.38 - 2837.58）的两倍。妊娠高血压疾病引产是引产最昂贵的产科指征（4347.32欧元，95%CI 3890.45 - 4804.18）。
引产之后，一些与患者和治疗相关的因素会影响分娩相关成本。
