TY - JOUR
T1 - Cost analysis for deliveries according to maternal age classes for moving to a personalized approach in the health care
AU - Triunfo, Stefania
AU - Petrillo, Francesca
AU - Lofoco, Francesca
AU - Volpe, Massimo
AU - Lanzone, Antonio
N1 - Funding Information:
The authors confirm that the research presented in this article met the ethical guidelines and received approval from the Local Institutional Board of the Catholic University (IRB 16_10_2017).
Publisher Copyright:
© 2019 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objective: In the last decades, childbearing has moved to higher ages, displaying adverse outcomes related to advanced maternal age at birth. Accordingly, the aim was to perform a cost analysis in women admitted for birth assistance and segregated by age classes (<20, 20–24, 25–29, 30–34, 35–39, 40–45, and ≥45 years). Methods: A total of 18,093 admitted for assistance at delivery in a 5-year period (2012–2016) were included in the analysis. Costs for obstetric complications in vaginal delivery (VD) and cesarean section (CS), based on hospital discharge report from the local health care system, were calculated by using the “diagnosis-related group” (DRG) approach. Results: An overall economic cost due to clinical assistance at delivery of €42.663.481 was computed. A global rate of 59.6% of vaginal deliveries (VD) and 40.4% of cesarean section (CS) was assessed. Among of all maternal age classes, women attributable to classes 30–34 and 35–39 years reached a rate of 62.8%, while values of 24.2 and 13% were observed for those under 30 and over 40 years of age, respectively. A significant increasing trend in terms of maternal stay duration was found across all age groups (from 4.7 to 5.4 days, p <.05), as well as nonspecific delivery costs (from €2.222.49 to €2.401.29, p <.05). Uncomplicated VD decreased across the groups, until to halve between two extreme maternal age groups (38.8 versus 18.6%, p <.05), while a three-fold risk of CS complications was calculated in women over 45 years-old in comparison with those under 20 years of age (4.2 versus 13.9, p <.05), although not significantly different in the cost analysis between two extreme age groups. Conclusions: Increases in maternal age at delivery are associated with higher healthcare costs, driven largely by additional complication rates, irrespective of the delivery mode.
AB - Objective: In the last decades, childbearing has moved to higher ages, displaying adverse outcomes related to advanced maternal age at birth. Accordingly, the aim was to perform a cost analysis in women admitted for birth assistance and segregated by age classes (<20, 20–24, 25–29, 30–34, 35–39, 40–45, and ≥45 years). Methods: A total of 18,093 admitted for assistance at delivery in a 5-year period (2012–2016) were included in the analysis. Costs for obstetric complications in vaginal delivery (VD) and cesarean section (CS), based on hospital discharge report from the local health care system, were calculated by using the “diagnosis-related group” (DRG) approach. Results: An overall economic cost due to clinical assistance at delivery of €42.663.481 was computed. A global rate of 59.6% of vaginal deliveries (VD) and 40.4% of cesarean section (CS) was assessed. Among of all maternal age classes, women attributable to classes 30–34 and 35–39 years reached a rate of 62.8%, while values of 24.2 and 13% were observed for those under 30 and over 40 years of age, respectively. A significant increasing trend in terms of maternal stay duration was found across all age groups (from 4.7 to 5.4 days, p <.05), as well as nonspecific delivery costs (from €2.222.49 to €2.401.29, p <.05). Uncomplicated VD decreased across the groups, until to halve between two extreme maternal age groups (38.8 versus 18.6%, p <.05), while a three-fold risk of CS complications was calculated in women over 45 years-old in comparison with those under 20 years of age (4.2 versus 13.9, p <.05), although not significantly different in the cost analysis between two extreme age groups. Conclusions: Increases in maternal age at delivery are associated with higher healthcare costs, driven largely by additional complication rates, irrespective of the delivery mode.
KW - Cesarean section
KW - costs
KW - delivery
KW - maternal age
KW - maternal morbidity
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U2 - 10.1080/14767058.2019.1605592
DO - 10.1080/14767058.2019.1605592
M3 - Article
C2 - 30957596
AN - SCOPUS:85064731873
VL - 34
SP - 223
EP - 230
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
SN - 1476-7058
IS - 2
ER -