Economic consequences of over-diagnosis of threatened preterm labor.

Autor: Coloma M; Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain., Kang F; Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain., Vallejo-Torres L; Servicio de Evaluación del Servicio Canario de la Salud, Fundación Canaria de Investigación Sanitaria, Tenerife, Spain., Díaz P; Universidad de La Laguna, Tenerife, Spain., Méndez Y; Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain., Álvarez de la Rosa M; Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2018 May; Vol. 141 (2), pp. 200-205. Date of Electronic Publication: 2018 Feb 14.
DOI: 10.1002/ijgo.12450
Abstrakt: Objective: To investigate whether adherence to a cervical length-based protocol can reduce both unnecessary admissions and the socioeconomic costs associated with inappropriately admitted patients.
Methods: The present retrospective observational study included women admitted for threatened preterm labor (TPL) at 24-34 weeks of pregnancy to a tertiary hospital in the Canary Islands, 2009-2014. Data were reviewed from all patients admitted for TPL. Those with a long cervix (>25 mm) were classified as "inappropriate admissions", and both the economic burden based on diagnosis-related group (DRG) and the social costs associated with sick leave for these women were calculated.
Results: During the 6-year study period, 430 women were admitted for TPL. The rate of inappropriate hospital admissions was 45% in the first year, but was reduced to 23% in the final year (P<0.001); the premature delivery rates in these years did not differ (P=0.224). The mean DRG-based cost of the admission per patient with a long cervix was EU euros €2099. The total annual costs from inappropriate admission (both social security sick leave costs and hospital costs) were estimated to be up to €571 047.37 during the 6-year study period, and reduced from €60 420.76 in 2009 to €29 998.04 in 2014.
Conclusion: Reductions in inappropriate admissions from applying cervical length-based management protocol could reduce healthcare costs without increasing the incidence of premature delivery.
(© 2018 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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