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An economic analysis of trial of labor after cesarean delivery.
- Source :
-
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2016; Vol. 29 (7), pp. 1030-5. Date of Electronic Publication: 2015 Apr 13. - Publication Year :
- 2016
-
Abstract
- Objective: Given that cesarean delivery is one of the most commonly performed surgical procedures in the United States and an important contributor to obstetric care costs, this analysis sought to examine maternal hospital costs associated with trial of labor after cesarean delivery (TOLAC) versus repeat cesarean delivery (RCD).<br />Methods: A national sample was used to identify women with singleton pregnancy who underwent either TOLAC or RCD from 2006 to 2012. Women with diagnoses that could confound cost via extended hospital length of stay prior to delivery were excluded. Other medical and obstetric covariates that could influence cost were included in an adjusted model.<br />Results: A total of 485,247 women were identified, including 365,596 (75.3%) cesarean deliveries without labor, 41,988 (8.6%) successful and 77,663 (16.0%) unsuccessful TOLAC deliveries. The inflation-adjusted median costs in this cohort were $5512 for cesarean without labor, $4175 for successful TOLAC, $5166 for all TOLAC attempts, and $5759 for failed TOLAC. In a multivariable model, hospital region was a major predictor of median cost as were demographic variables and medical comorbidities.<br />Conclusion: TOLAC is associated with modest reductions of cost for maternal hospitalizations. However, other medical, demographic and hospital factors appear to be more important factors.
- Subjects :
- Adolescent
Adult
Cesarean Section, Repeat economics
Cesarean Section, Repeat statistics & numerical data
Cost-Benefit Analysis
Female
Humans
Infant, Newborn
Length of Stay economics
Length of Stay statistics & numerical data
Middle Aged
Obstetric Labor Complications epidemiology
Pregnancy
Risk Factors
United States epidemiology
Uterine Rupture economics
Uterine Rupture epidemiology
Uterine Rupture etiology
Uterine Rupture therapy
Vaginal Birth after Cesarean adverse effects
Vaginal Birth after Cesarean statistics & numerical data
Young Adult
Obstetric Labor Complications economics
Trial of Labor
Vaginal Birth after Cesarean economics
Subjects
Details
- Language :
- English
- ISSN :
- 1476-4954
- Volume :
- 29
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
- Publication Type :
- Academic Journal
- Accession number :
- 25865742
- Full Text :
- https://doi.org/10.3109/14767058.2015.1035250