Societal costs of antenatal and obstetrical care

Abstract

Perinatal health care is an important part of a nation's health care system. In the Nordic countries this type of health care is provided by the national public health systems without cost for the women. The societal costs of the care provided have, however, not been known. The aim of the present study was to estimate societal costs of antenatal and obstetrical care in a Norwegian county during a twelve month period 1988-89. A total of 1908 women delivered during the registration period. The mean total cost was estimated to NOK 36.300 per woman. Primary care antenatal visits accounted for 8%, outpatient visits (inclusive ultrasound screening) 4%, and hospital care in connection with delivery represented 36% of the total cost. The major determinant of societal costs was sick leave during pregnancy, contributing 43% to the total cost. This underlines the importance of the ongoing debate about sick leave in pregnancy. The mean cost of primary care based antenatal care, averaging 10.8 visits per woman, was estimated to NOK 2.800. An important factor was use of patients' own time, accounting for 35% of this amount. The prevalence at the time of admission for delivery of five important complications or obstetrical conditions (pre-eclampsia, placenta previa, intrauterine growth retardation, twin pregnancy, and breech presentation) was recorded. The mean total societal cost for women with the indicator conditions was approximately one fifth greater than for women without any of the indicator conditions.

British National Health Service's and women's costs of antenatal ultrasound screening and follow‐up tests

“…The UK study by Long & Sprigg (1998) 10 found costs very similar to ours. The reported costs from the two Scandinavian studies were somewhat higher 11,12 .…”

“…This was at least partly due to the duration of scans being greater in Helsinki. The Norwegian study 12 was a more general study of costs of antenatal and obstetric care. It was not clear what had been included in the cost of a scan but it was very similar to the Finnish figure.…”

Antenatal ultrasound screening for fetal abnormalities: a systematic review of studies of cost and cost effectiveness

“…This was much higher than the cost of any of the routine scans estimated in the costing study we carried out at Liverpool, which averaged between £14 and £16, depending on the purpose of the scan. Only three studies, however, presented data for the cost of ultrasound 10,11,20 . The average cost of a scan in these three studies was £35.42.…”

“…of equipment), and others are average costs per woman tested. Two studies 10,20 also considered the woman's travel costs. At UK prices in 1997 these averaged between £1.43 and £16.65.…”

Paper title with footnote if needed

“…The relative cost-effectiveness of the two programmes of antenatal care may change considerably when women's costs are included, as has been shown elsewhere. 20,21 This leads us to ask whose viewpoint the analysis should represent. While it is important for an economic evaluation to adopt a societal perspective in order to illustrate where the most benefit could be gained, the costs of different agencies should also be presented separately, as they may highlight conflicts in incentive to change practice.…”