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| Autor | Domingues, Rosa Maria Soares Madeira | |
| Autor | Luz, Paula Mendes | |
| Autor | Ayres, Barbara Vasques da Silva | |
| Autor | Torres, Jacqueline Alves | |
| Autor | Leal, Maria do Carmo | |
| Fecha de acceso | 2021-06-22T13:26:52Z | |
| Fecha de disponibilización | 2021-06-22T13:26:52Z | |
| Fecha de publicación | 2021 | |
| Referencia | DOMINGUES, Rosa Maria Soares Madeira et al. Cost-effectiveness analysis of a quality improvement program to reduce caesarean sections in Brazilian private hospitals: a case study. Reproductive Health, v. 18, n. 1, p. 1-13, 2021. | pt_BR |
| ISSN | 1742-4755 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/47833 | |
| Idioma | eng | pt_BR |
| Editor | BMC | pt_BR |
| Derechos de autor | open access | pt_BR |
| Título | Cost-effectiveness analysis of a quality improvement program to reduce caesarean sections in Brazilian private hospitals: a case study | pt_BR |
| Tipo del documento | Article | pt_BR |
| DOI | 10.1186/s12978-021-01147-2 | |
| Resumen en Inglés | Background: In 2015, a quality improvement project of childbirth care called Adequate Childbirth Project ("Projeto Parto Adequado"- PPA) was implemented in Brazilian public and private hospitals, aiming to improve the quality of childbirth care and to reduce caesarean sections without clinical indications. The objective of this study is to conduct an economic analysis of two models of care existing in a private Brazilian hospital-the model following the recommendations of the PPA and the standard of care model-in reducing the proportion of caesarean sections. Methods: We conducted a cost-effectiveness analysis using data from one of the private hospitals included in the PPA project. The main outcome was the proportion of caesarean section. We used total cost of hospitalization for women and newborns, from the health care sector perspective, during the length of the observed hospital stay. We did not apply discount rates and inflation rate adjustments due to the short time horizon. We conducted univariate sensitivity analysis using the minimum and maximum costs observed in hospitalizations and variation in the probabilities of caesarean section and of maternal and neonatal complications. Results: 238 puerperal women were included in this analysis. The PPA model of care resulted in a 56.9 percentage point reduction in the caesarean section probability (88.6% vs 31.7%, p < 0.001) with an incremental cost-effectiveness ratio of US$1,237.40 per avoided caesarean section. Women in the PPA model of care also had a higher proportion of spontaneous and induced labor and a lower proportion of early term births. There were no maternal, fetal or neonatal deaths and no significant differences in cases of maternal and neonatal near miss. The cost of uncomplicated vaginal births and caesarean sections was the parameter with the greatest impact on the cost-effectiveness ratio of the PPA model of care. Conclusion: The PPA model of care was cost-effective in reducing caesarean sections in women assisted in a Brazilian private hospital. Moreover, it reduced the frequency of early term births and did not increase the occurrence of severe negative maternal and neonatal outcomes. | pt_BR |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Afiliación | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Afiliación | Agência Nacional de Saúde Suplementar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Afiliación | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Palavras clave en Inglês | Caesarean delivery | pt_BR |
| Palavras clave en Inglês | Cost-effectiveness | pt_BR |
| Palavras clave en Inglês | Healthcare quality improvement | pt_BR |
| Palavras clave en Inglês | Hospitals medicine | pt_BR |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar |
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