[Budgetary impact of spontaneous vaginal delivery and elective cesarean section without clinical indication in BrazilImpacto presupuestario del parto vaginal espontáneo y de la cesárea electiva sin indicación clínica en Brasil].

Autor:	Entringer AP; Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), Rio de Janeiro (RJ), Brasil., Gomes MASM; Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), Rio de Janeiro (RJ), Brasil., da Costa ACC; Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), Rio de Janeiro (RJ), Brasil., Pinto M; Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), Rio de Janeiro (RJ), Brasil.
Jazyk:	portugalština
Zdroj:	Revista panamericana de salud publica = Pan American journal of public health [Rev Panam Salud Publica] 2018 Sep 07; Vol. 42, pp. e116. Date of Electronic Publication: 2018 Sep 07 (Print Publication: 2018).
DOI:	10.26633/RPSP.2018.116
Abstrakt:	Objective: To estimate the budgetary impact of excess cesarean deliveries without clinical indication compared to vaginal deliveries in the Unified Health System (SUS) in Brazil. Methods: The analysis was based on a static model. The reference population was that of pregnant women at normal risk. The time horizon was 5 years. A Poisson regression model was used to estimate the number of live births from 2016 to 2020. Calculation of the direct cost of elective cesarean delivery and vaginal delivery was based on two previous studies, in which the expected monetary value of the procedures was calculated through an analytical decision model that included all clinical events from admission until discharge. The reference scenario for this analysis considered 29% of excess cesareans in the country. Results: The total cost of delivery and birth care for primiparous and multiparous women without uterine scar in the reference scenario was US$ 707 500 000 for the year 2016. In scenario 1 (best scenario), which considered only vaginal delivery for these pregnant women, there was a cost reduction of US$ 76 500 000 per year. For multiparous women, comparison of the reference scenario with the best scenario showed savings of more than US$ 4 000 000 per year. Conclusions: The results indicate that the incentive to vaginal delivery generates savings. Competing Interests: Conflitos de interesse. Nada declarado pelos autores.
Databáze:	MEDLINE
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