The Cost of Managing Postpartum Hemorrhage: An Analysis by a Brazilian Health Insurer
Author(s)
Francisco Prota, Ph.D1, Sérgio Rachkorsky, MD2, Gustavo Ribeiro Neves, MD2, Julio Cesar Prestes, MD2, Fernanda Trevisan Maldonado, MD2.
1Pontifical Catholic University of Campinas (PUCCAMP), CAMPINAS, Brazil, 2Unimed Sorocaba, Sorocaba, Brazil.
1Pontifical Catholic University of Campinas (PUCCAMP), CAMPINAS, Brazil, 2Unimed Sorocaba, Sorocaba, Brazil.
Presentation Documents
OBJECTIVES: To assess clinical, economic, and hospital outcomes of postpartum hemorrhage (PPH) in a Brazilian insurer-linked hospital.
METHODS: This retrospective study was conducted at a hospital belonging to Unimed Sorocaba, a health insurer covering 150,000 lives. Data from electronic medical records and administrative registers from September 2021 to October 2024 were analyzed, focusing on patients diagnosed with PPH. The variables included age, delivery type, length of hospitalization, resource utilization, hospital costs, the need for blood transfusion (BT), and hysterectomy.
RESULTS: A total of 6,535 deliveries occurred during the study period, of which 5.5% (n=358) resulted in PPH. The average age of patients was 33.1 years (18-46), with the highest prevalence (50.3%) in the 31-38 age range. Cesarean deliveries accounted for 87% of all births. Of the PPH patients, 19.5% (n=70) required ICU admission. The total hospitalization cost for PPH patients was USD1,134,790.40, with an average cost of USD3,173.26 (USD1,083.92-35,070.97). Forty-five percent of the total costs were related to hospital stays, and 40% were attributed to diagnostic and therapeutic procedures. The average length of stay was 4.5±4.4 days, and 37% of patients received multiple medications for hemorrhage control. Additionally, 10 patients (2.79%) underwent hysterectomy. Patients who required blood transfusion (29%; n=68) incurred significantly higher total costs (158.9%) and average costs (64%), primarily due to increased costs for procedures (254%) and hospital stays (177%). They also had longer hospitalizations (5.87±4.48 vs. 4.22±4.37 days; p<0.01), more frequent use of multiple medications (78% vs. 25%), and higher rates of hysterectomy (80%).
CONCLUSIONS: PPH represents a significant burden on the healthcare system, particularly for patients requiring blood transfusion, due to the higher consumption of resources and extended hospitalization. These findings underscore the need for preventive strategies and early interventions to reduce complications, healthcare costs, and to improve maternal outcomes.
METHODS: This retrospective study was conducted at a hospital belonging to Unimed Sorocaba, a health insurer covering 150,000 lives. Data from electronic medical records and administrative registers from September 2021 to October 2024 were analyzed, focusing on patients diagnosed with PPH. The variables included age, delivery type, length of hospitalization, resource utilization, hospital costs, the need for blood transfusion (BT), and hysterectomy.
RESULTS: A total of 6,535 deliveries occurred during the study period, of which 5.5% (n=358) resulted in PPH. The average age of patients was 33.1 years (18-46), with the highest prevalence (50.3%) in the 31-38 age range. Cesarean deliveries accounted for 87% of all births. Of the PPH patients, 19.5% (n=70) required ICU admission. The total hospitalization cost for PPH patients was USD1,134,790.40, with an average cost of USD3,173.26 (USD1,083.92-35,070.97). Forty-five percent of the total costs were related to hospital stays, and 40% were attributed to diagnostic and therapeutic procedures. The average length of stay was 4.5±4.4 days, and 37% of patients received multiple medications for hemorrhage control. Additionally, 10 patients (2.79%) underwent hysterectomy. Patients who required blood transfusion (29%; n=68) incurred significantly higher total costs (158.9%) and average costs (64%), primarily due to increased costs for procedures (254%) and hospital stays (177%). They also had longer hospitalizations (5.87±4.48 vs. 4.22±4.37 days; p<0.01), more frequent use of multiple medications (78% vs. 25%), and higher rates of hysterectomy (80%).
CONCLUSIONS: PPH represents a significant burden on the healthcare system, particularly for patients requiring blood transfusion, due to the higher consumption of resources and extended hospitalization. These findings underscore the need for preventive strategies and early interventions to reduce complications, healthcare costs, and to improve maternal outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE33
Topic
Economic Evaluation
Topic Subcategory
Value of Information
Disease
SDC: Reproductive & Sexual Health, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)