Costs of alternative methods of child delivery in Serbia

Abstract

Objectives: Different types of labour need different resources. Therefore, different costs could be expected. Objectives of this study were to determine if sig- nificant differences in costs of different type of labour and methods of delivery exist and to determine factors related to estimated costs. The costs of spontaneous labour with vaginal delivery (SVD), induced labour with vaginal delivery (IVD), and planned C-section (CS) without labour were estimated. MethOds: Retrospective, population- based study was conducted for the period January – December, 2010. Health Insurance Fund of Republic of Serbia (HIFRS) database was used as a data source. Direct medical costs of mother/newborn pair were estimated. Costs were observed from the perspec- tive of HIFRS and expressed in European Monetary Unit (EUR). Results: A total of 99 women were selected for the study sample; average age was 30.55±5.42 years. The majority of women (46.5%) had SVD, 28.3% had IVD and 25.2% had CS. Women with CS were longer hospitalized compared to women with SVD and IVD (8.52±4.74 vs. 4.59±2.89 and 5.04±3.01 days, respectively, p<0.05). Newborns after CS were longer hos- pitalized compared to newborns after SVD and IVD (5.76±2.20 vs. 4.0±2.07 (p<0.05) and 5.14±3.39 (p>0.05)). Majority of women (88.0%) and children (80.0%) after CS were hos- pitalized at semi-intensive and/or intensive care unites. The average costs of delivery, regardless of the method, were 417.02±284.14 EUR. The costs of C-section were higher compare to SVD (640.18±240.04 vs. 243.27±131.70 EUR, p<0.05) and IVD (640.18±240.04 vs. 497.10±327.91 EUR, p>0.05). cOnclusiOns: The highest costs of labour in Serbia were costs of planned CS. Longer maternal/newborns hospital stay and more frequent hospitalization at semi-intensive and/or intensive care unites after CS were leading factors of estimated high costs. Considering high costs of CS, it is neces- sary to review such clinical practice for the purpose of optimizing the use of resources.