Traynor J D, Peaceman A M
Department of Obstetrics and Gynecology at Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, Illinois 60611, USA.
Birth. 1998 Jun;25(2):81-4. doi: 10.1046/j.1523-536x.1998.00081.x.
Although cesarean section is known to be associated with higher hospital charges than vaginal delivery, cost comparisons require further investigation. This study compared maternal hospital charges of women with one previous cesarean section undergoing a trial of labor with the charges of women who underwent an elective repeat cesarean section. Hospital charges for the trial of labor group were also compared with charges of women with a previous vaginal delivery but no previous cesarean section.
A retrospective analysis of three primiparous privately insured patient groups who gave birth from July 1992 to October 1993 was conducted. Hospital charges for 50 primiparas with previous cesarean births who underwent a trial of labor were compared with those of 50 contemporaneous primiparas who underwent elective repeat cesarean section, and with those of 50 primiparas without a past history of cesarean birth.
Trial of labor was associated with a mean maternal hospital charge of $5820 +/- $1609 compared with $6785 +/- $771 for elective repeat cesarean section (p < 0.001). Trial of labor was also associated with a decreased length of stay when compared with elective cesarean section (2.48 +/- 0.88 days vs 3.62 +/- 0.57 days, p < 0.001). The difference in charges between these two groups was primarily due to charges associated with length of stay and the operating room, but was partly offset by charges associated with labor. The group of women without a past history of cesarean birth had a mean maternal hospital charge of $4685 +/- $966 and a mean length of stay of 1.96 +/- 0.63 days.
Trial of labor is associated with an overall 14 percent reduction in maternal hospital charges and a 31 percent reduction in length of stay compared with elective repeat cesarean section.
虽然已知剖宫产与比阴道分娩更高的住院费用相关，但成本比较仍需进一步研究。本研究比较了有一次剖宫产史且接受引产的产妇的住院费用与接受择期再次剖宫产的产妇的费用。引产组的住院费用也与有过阴道分娩但无剖宫产史的产妇的费用进行了比较。
对1992年7月至1993年10月分娩的三组初产且有私人保险的患者进行回顾性分析。将50例有剖宫产史且接受引产的初产妇的住院费用与50例同期接受择期再次剖宫产的初产妇以及50例无剖宫产史的初产妇的住院费用进行比较。
引产产妇的平均住院费用为5820美元±1609美元，而择期再次剖宫产的费用为6785美元±771美元（p<0.001）。与择期剖宫产相比，引产还与住院时间缩短有关（2.48天±0.88天对3.62天±0.57天，p<0.001）。这两组之间费用的差异主要是由于与住院时间和手术室相关的费用，但部分被与分娩相关的费用所抵消。无剖宫产史的产妇组的平均住院费用为4685美元±966美元，平均住院时间为1.96天±0.63天。
与择期再次剖宫产相比，引产可使产妇住院费用总体降低14%，住院时间缩短31%。
