Key result
Anesthesia-related adverse events during labor and delivery were associated with an adjusted excess cost of $1189 (95% CI, 1033-1350).
Why the study?
What are the excess costs and cost per admission associated with anesthesia-related adverse events during labor and delivery?
Observational (n=228,104)
Yes
What are the excess costs and cost per admission associated with anesthesia-related adverse events during labor and delivery?
Anesthesia-related adverse events during labor and delivery are associated with significant excess costs, though less than those for preeclampsia/eclampsia and postpartum hemorrhage.
Answers are grounded in this paper and cite their sources.
Anesthesia adverse events in labor add costs; observational data leaves open whether prevention reduces expenditures.
BACKGROUND: The safety of anesthetic care provided during childbirth has improved during the past 2 decades in the United States, with a marked decrease in the rate of anesthesia-related adverse events (ARAEs). To date, there is little research on the costs of ARAEs in obstetrics. This study aims to assess the excess cost and cost per admission associated with ARAEs during labor and delivery. METHODS: Data came from the New York State Inpatient Database 2010. Discharge records indicating labor and delivery and ARAEs were identified with International Classification of Diseases, Ninth Revision, Clinical Modification codes. ARAEs were defined as minor if not associated with maternal death, cardiac arrest, or severe morbidity. Costs were calculated as the product of hospital charges and the group average all-payer inpatient charge-to-cost conversion ratio. Excess cost was calculated as the difference between the mean cost of discharges with and without ARAEs. The cost per admission was calculated as the product of the excess cost and ARAE incidence. Excess costs and cost per admission were also calculated for 2 pregnancy-related complications: postpartum hemorrhage and preeclampsia/eclampsia. RESULTS: There were 228,104 delivery-related discharges in the study; of these, 1053 recorded at least 1 ARAE (4.6 per 1000), with 1034 (98.2%) of the ARAEs being minor. The adjusted excess cost associated with ARAEs was $1189 (95% confidence interval [CI], 1033-1350) and the cost per admission $5.49 (95% CI, 4.77-6.23). The incidence of postpartum hemorrhage and preeclamspia/eclampsia was 25.1 and 43.8 per 1000, respectively. The adjusted excess cost was $679 (95% CI, 608-748) and $1328 (95% CI, 1272-1378), respectively; the cost per admission was $17.07 (95% CI, 15.27-18.81) and $58.16 (95% CI, 55.72-60.34), respectively. CONCLUSIONS: ARAEs during labor and delivery are associated with significant excess cost. However, the excess cost per admission for ARAEs is significantly less compared with the excess cost per admission for preeclampsia/eclampsia and postpartum hemorrhage.
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Hunt et al. (2016) conducted an observational in Labor and delivery (n=228,104). Anesthesia-related adverse events (ARAEs) vs. Discharges without ARAEs was evaluated on Adjusted excess cost (MD 1189, 95% CI 1033-1350). Anesthesia-related adverse events during labor and delivery were associated with an adjusted excess cost of $1189 (95% CI, 1033-1350).
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