Estimating costs of post-abortion services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico

Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of maternal mortality in Mexico. Strengthening the capacity of health care institutions to provide high-quality post-abortion care services that are cost-effective, accessible, and sustainable is a major public health objective. To improve its service-delivery model, the Aurelio Valdivieso General Hospital in Oaxaca implemented a redesigned service model for women seeking care for incomplete abortion. The study detailed in this report assesses the cost and quality implications of this new service model.