Division of Social and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
Department of Pharmaceutics, University of Pharmacy, Yangon, Ministry of Health and Sports, Myanmar.
PLoS One. 2019 Mar 20;14(3):e0213141. doi: 10.1371/journal.pone.0213141. eCollection 2019.
Maternal health still remains a major challenge in almost all developing countries. In Myanmar, the country met only 62% of its target for the maternal mortality rate (130 per 100,000 live birth) even though proportion of skilled birth attendant (SBA) and antenatal care (ANC) coverage was 80% in 2015. Despite the estimated large maternal complications, most maternal healthcare program ignored the burden of those morbidity because of limited understanding of the incidence and prevalence of morbidity conditions and cost of those morbidity burdens on society. The present study provides a general idea of the scope of obstetric complication, incidence of obstetric complication, and cost of those morbidity burdens on society. We conducted a retrospective incidence-based cost of illness study related to obstetric complication from the healthcare system perspective at 25 bedded township hospital in Yedashae during the fiscal year of 2015-2016. For the cost of obstetric complication, average treatment cost was 26.83 USD (±8.59). When looking by disease category, average treatment cost for incomplete abortion was 35.45 USD (±1.75); pelvic inflammatory disease (PID) was 16.01 USD; pregnancy-induced hypertension (PIH) was 21.02 USD (±4.68); ante-partum hemorrhage (APH) was 14.24(± 0.25); post-partum hemorrhage (PPH) was 27.04 USD (±1.56); prolonged labor was 37.55 USD (±0.42); and septicemia was 16.51 USD (±2.15). Significant predicting variables in obstetric complication cost model were incomplete abortion, prolonged labor, post-partum hemorrhage (PPH), pregnancy induced hypertension (PIH), patient age and septicemia. From this study, we can summarize the most frequently occurred obstetric complication in that township area, actual cost burden of those complications and obstetric complication cost model which can be useful for hospital financial management. This study can be considered as a starting point for cost of illness analysis in Myanmar to prioritize and target specific health problem at a country level for policy maker to set priorities for health care intervention.
在几乎所有发展中国家,孕产妇健康仍然是一个主要挑战。在缅甸,该国的孕产妇死亡率目标(每 10 万例活产 130 例)仅达到 62%,尽管 2015 年熟练接生员和产前护理的比例分别为 80%。尽管估计有大量产妇并发症,但由于对发病率和患病率状况以及这些发病率负担对社会的成本了解有限,大多数孕产妇保健方案忽略了这些发病率负担。本研究提供了关于产科并发症范围、产科并发症发生率和这些发病率负担对社会成本的一般认识。我们从医疗保健系统的角度,对耶德沙耶 25 张病床的乡镇医院在 2015-2016 财政年度的产科并发症进行了基于回顾性发病率的疾病成本研究。对于产科并发症的成本,平均治疗费用为 26.83 美元(±8.59)。按疾病类别来看,不完全流产的平均治疗费用为 35.45 美元(±1.75);盆腔炎(PID)为 16.01 美元;妊娠高血压(PIH)为 21.02 美元(±4.68);产前出血(APH)为 14.24(±0.25);产后出血(PPH)为 27.04 美元(±1.56);产程延长为 37.55 美元(±0.42);败血症为 16.51 美元(±2.15)。产科并发症成本模型中的显著预测变量为不完全流产、产程延长、产后出血(PPH)、妊娠高血压(PIH)、患者年龄和败血症。通过这项研究,我们可以总结出该乡镇地区最常见的产科并发症、这些并发症的实际成本负担以及产科并发症成本模型,这对医院财务管理非常有用。这项研究可以被视为缅甸疾病成本分析的一个起点,以便为决策者在国家层面确定卫生保健干预措施的优先事项,针对具体的健康问题进行优先排序。