Período prenatal de gestantes de riesgo habitual con enfermera obstetra y partera: Costo-efectividad desde la perspectiva del Sistema de Salud Suplementario

Autor: de Oliveira Menezes, Mariane [UNESP], Knobel, Roxana, Andreucci, Carla Betina, Magalhães, Claudia Garcia [UNESP], Ramos Amorim, Melania Maria, Katz, Leila, Soligo Takemoto, Maíra Libertad [UNESP]
Přispěvatelé: Universidade Estadual Paulista (UNESP), Universidade Federal de Santa Catarina (UFSC), Universidade Federal de São Carlos (UFSCar), Instituto de Medicina Integral Prof. Fernando Figueira
Jazyk: portugalština
Rok vydání: 2021
Předmět:
Zdroj: Scopus
Repositório Institucional da UNESP
Universidade Estadual Paulista (UNESP)
instacron:UNESP
Popis: Made available in DSpace on 2022-04-28T19:45:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 In several countries, primary care for pregnant women is performed by obstetric nurses and/or midwives. In Brazil’s Supplementary Health System (private health insurance and out-of-pocket care), coverage of prenatal care is mandatory and is performed by medical obstetricians. The objective of this study is to conduct a cost-effectiveness analysis, comparing clinical outcomes and costs associated with the incorporation of prenatal care by obstetric nurses and midwives in the Supplementary Health System, from the perspective of the operator of health plans as the payment source. A decision tree was built, based on data from a Cochrane Collaboration meta-analysis that showed a reduction in the risk of premature birth in the group of normal-risk pregnant women accompanied by obstetric nurses and midwives. The analysis only considered the direct medical costs covered by health plan operators for essential appointments and tests, according to the prevailing Ministry of Health protocol. The study assumed equal unit costs of consultations by medical professionals and applied an increase in the overall cost of prenatal tests associated with medical follow-up, based on data from the literature. Incremental cost-effective ratio was estimated at -BRL 10,038.43 (savings of BRL 10,038.43) per premature birth avoided. This result was consistent with the sensitivity analyses, with savings associated with the substitution ranging from -BRL 2,544.60 to -BRL 31,807.46 per premature death avoided. In conclusion, prenatal care provided by obstetric nurses and midwives was superior to that provided by medical obstetricians for the prevention of premature birth, besides resulting in cost savings. Universidade Estadual Paulista Universidade Federal de Santa Catarina Universidade Federal de São Carlos Instituto de Medicina Integral Prof. Fernando Figueira Universidade Estadual Paulista
Databáze: OpenAIRE
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