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Economic consequences of over‐diagnosis of threatened preterm labor
Author(s) -
Coloma Marta,
Kang Fatima,
VallejoTorres Laura,
Díaz Paloma,
Méndez Yurena,
Álvarez de la Rosa Margarita
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12450
Subject(s) - medicine , observational study , sick leave , emergency medicine , incidence (geometry) , retrospective cohort study , socioeconomic status , pediatrics , pregnancy , obstetrics , environmental health , population , surgery , physical therapy , physics , biology , optics , genetics
Objective To investigate whether adherence to a cervical length‐based protocol can reduce both unnecessary admissions and the socioeconomic costs associated with inappropriately admitted patients. Methods The present retrospective observational study included women admitted for threatened preterm labor ( TPL ) at 24–34 weeks of pregnancy to a tertiary hospital in the Canary Islands, 2009–2014. Data were reviewed from all patients admitted for TPL . Those with a long cervix (>25 mm) were classified as “inappropriate admissions”, and both the economic burden based on diagnosis‐related group ( DRG ) and the social costs associated with sick leave for these women were calculated. Results During the 6‐year study period, 430 women were admitted for TPL . The rate of inappropriate hospital admissions was 45% in the first year, but was reduced to 23% in the final year ( P <0.001); the premature delivery rates in these years did not differ ( P =0.224). The mean DRG ‐based cost of the admission per patient with a long cervix was EU euros €2099. The total annual costs from inappropriate admission (both social security sick leave costs and hospital costs) were estimated to be up to €571 047.37 during the 6‐year study period, and reduced from €60 420.76 in 2009 to €29 998.04 in 2014. Conclusion Reductions in inappropriate admissions from applying cervical length‐based management protocol could reduce healthcare costs without increasing the incidence of premature delivery.