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Servicio de ambulancia dentro de una intervención integral de salud reproductiva en un emplazamiento remoto: una intervención costo‐efectiva
Author(s) -
Somigliana Edgardo,
Sabino Alice,
Nkurunziza Richard,
Okello Emmy,
Quaglio Gianluca,
Lochoro Peter,
Putoto Giovanni,
Manenti Fabio
Publication year - 2011
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2011.02819.x
Subject(s) - medicine , psychological intervention , reproductive health , referral , medical emergency , cost effectiveness , emergency medicine , nursing , environmental health , population , risk analysis (engineering)
Summary Objective To assess the cost‐effectiveness of an ambulance service within a comprehensive hospital/community‐based program aimed at improving access and quality of reproductive health in poor‐resources settings. Methods Obstetrical cases referred to the hospital with the ambulance during a 3‐month period were prospectively recorded. Clinical indications were used to determine the effectiveness of the referral; the direct costs of the service were calculated. Overall effectiveness was then measured against WHO thresholds. Results Ninety‐two obstetrical referrals were recorded. Eleven (12%) were considered effective, corresponding to 611.7 years saved. Cost per year saved was 15.82 US dollars which about half of WHO’s 30 US dollar benchmark defining very attractive interventions. Sensitivity analyses on the costs of the ambulance and the rate of effective referrals emphasized the robustness of the result. Conclusions The cost‐effectiveness profile of an ambulance service within a series of interventions aimed at improving reproductive health in remote settings is very attractive.