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. 2021 Apr 26;21(1):333.
doi: 10.1186/s12884-021-03798-2.

Value-based care in obstetrics: comparison between vaginal birth and caesarean section

Romulo Negrini  1 , Raquel Domingues da Silva Ferreira  2 , Daniela Zaros Guimarães  2
Affiliations

Value-based care in obstetrics: comparison between vaginal birth and caesarean section

Romulo Negrini et al. BMC Pregnancy Childbirth. .

Abstract

Background: Healthcare costs have substantially increased in recent years, threatening the population health. Obstetric care is a significant contributor to this scenario since it represents 20% of healthcare. The rate of cesarean sections (C-sections) has escalated worldwide. Evidence shows that cesarean delivery is not only more expensive, but it is also linked to poorer maternal and neonatal outcomes. This study assesses which type of delivery is associated with a higher healthcare value in low-risk pregnancies.

Results: A total of 9345 deliveries were analyzed. The C-section group had significantly worse rates of breastfeeding in the first hour after delivery (92.57% vs 88.43%, p < 0.001), a higher rate of intensive unit care (ICU) admission both for the mother and the newborn (0.8% vs 0.3%, p = 0.001; 6.7% vs 4.5%, p = 0.0078 respectively), and a higher average cost of hospitalization (BRL14,342.04 vs BRL12,230.03 considering mothers and babies).

Conclusion: Cesarean deliveries in low-risk pregnancies were associated with a lower value delivery because in addition to being more expensive, they had worse perinatal outcomes.

Keywords: Birth setting; Cesarean section; Delivery of healthcare; Healthcare cost; Obstetric delivery; Obstetrics; Quality of healthcare.

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Conflict of interest statement

There are no competing interests in this publication.

Figures

Fig. 1
Fig. 1
Breastfeeding rate in the first hour of life according to type of delivery and year of occurrence. CS = cesarean sections, VB = vaginal birth
Fig. 2
Fig. 2
Neonatal ICU admission rate according to type of delivery and year of birth. CS = cesarean sections, VB = vaginal birth
Fig. 3
Fig. 3
Maternal ICU admission rate according to type of delivery and year of occurrence. CS = C-sections, VB = vaginal birth
Fig. 4
Fig. 4
Hospital readmission rate up to 30 days from delivery according to type of delivery and year of occurrence. CS = C-sections, VB = vaginal birth
Fig. 5
Fig. 5
Average of parturition costs (in real) of hospitalization of the parturient-newborn binomial according to type of delivery and year of occurrence. CS = C-section, VB = Vaginal Birth
Fig. 6
Fig. 6
Average costs (in real) of maternal hospitalization for delivery according to type of delivery and year of occurrence. CS = C-section, VB = Vaginal birth
Fig. 7
Fig. 7
Average costs (in real) of hospitalization of the newborn due to delivery according to type of delivery and year of occurrence. CS = C-sections, VB = Vaginal birth
See this image and copyright information in PMC

References

    1. Xu K, Soucat A, Kutzin J, et al. Public spending on health: a closer look at global trends. World Health Organization (WHO); 2018.
    1. Silveira D. 2019. Available at https://g1.globo.com/economia/noticia/2019/12/20/gasto-de-brasileiros-co...; Accessed Dec 2019.
    1. Barros A in IBGE News. 2019. Available at https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-n...; Accessed Dec 2019.
    1. Ribeiro A, et al. Observatório 2019. ANHAP - Associação Nacional dos Hospitais Privados; 2019.
    1. Médici A, Ribeiro A, et al. Observatório 2020. ANHAP - Associação Nacional dos Hospitais Privados; 2020.

MeSH terms