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BMC Health Services Research

, 1:6

First Online: 04 July 2001Received: 08 March 2001Accepted: 04 July 2001DOI: 10.1186-1472-6963-1-6

Cite this article as: James, M., Hunt, K., Burr, R. et al. BMC Health Serv Res 2001 1: 6. doi:10.1186-1472-6963-1-6

Abstract

ObjectiveTo determine the care pathways and implications of offering mothers the choice of external cephalic version ECV at term for singleton babies who present with an uncomplicated breech pregnancy versus assisted breech delivery or elective caesarean.

DesignA prospective observational audit to construct a decision analysis of uncomplicated full term breech presentations.

SettingThe North Staffordshire NHS Trust.

SubjectsAll women n = 176 who presented at full term with a breech baby without complications during July 1995 and June 1997.

Main outcome measuresThe study determined to compare the outcome in terms of the costs and cost consequences for the care pathways that resulted from whether a women chose to accept the offer of ECV or not. All the associated events were then mapped for the two possible pathways. The costs were considered only within the hospital setting, from the perspective of the health care provider up to the point of delivery.

ResultsThe additional costs for ECV, assisted breech delivery and elective caesarean over and above a normal birth were £186.70, £425.36 and £1,955.22 respectively. The total expected cost of the respective care pathways for -ECV accepted- and -ECV not accepted- including the probability of adverse events were £1,452 and £1,828 respectively, that is the cost of delivery through the ECV care pathways is less costly than the non ECV delivery care pathway.

ConclusionsImplementing an ECV service may yield cost savings in secondary care over and above the traditional delivery methods for breech birth of assisted delivery or caesarean section. The scale of these expected cost savings are in the range of £248 to £376 per patient. This converts to a total expected cost saving of between £43,616 and £44,544 for the patient cohort considered in this study.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-1-6 contains supplementary material, which is available to authorized users.

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Autor: Marilyn James - Kevin Hunt - Robin Burr - Richard Johanson

Fuente: https://link.springer.com/







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