A COST-EFFECTIVENESS ANALYSIS OF DIFFERENT TYPES OF LABOR FOR SINGLETON PREGNANCY – REAL LIFE DATA
Author(s)
Lakic D1, Tadic I1, Odalovic M1, Petrovic B2, Petrova G3
1University of Belgrade Faculty of Pharmacy, Belgrade, Serbia and Montenegro, 2University Hospital for Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia and Montenegro, 3Medical University Sofia, Faculty of Pharmacy, Sofia, Bulgaria
OBJECTIVES: To assess cost, clinical outcomes and cost-effectiveness of different types of labor in singleton pregnancies. METHODS: A decision model was used to compare vaginal labor, induced labor and planned cesarean section. All data were taken from the Book of Labor from the University Hospital for Gynecology and Obstetrics “Narodni Front” in Serbia, for labors conducted during one month period in 2011. Successful delivery, (i.e. labor that began up to 42 gestation weeks, without maternal mortality and the newborn Apgar scores greater than or equal to seven in the first and fifth minute of life) was considered as the outcome of the cost effectiveness analysis. To test the robustness of this definition probabilistic sensitivity analysis was performed. RESULTS: From a total of 667 births, vaginal labor was conducted in 98 cases, induced vaginal in 442, while planned caesarean section was performed 127 times. Emergency caesarean section as a complication was much higher in the vaginal labor cohort compared to the induced vaginal cohort (OR = 17.374, 95% CI: 8.522 to 35.418, p < 0.001). The least costly type of labor was induced vaginal labor: average cost 461 euro, with an effectiveness of 98.17%. Both, vaginal and planned cesarean labor, were dominated by the induced labor. The results were robust. CONCLUSIONS: Elective induction of labor was associated with the lowest cost compared to other types of labor, with favorable maternal and neonatal outcomes.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PIH27
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Multiple Diseases, Reproductive and Sexual Health