Cost analysis - the desirability of natural delivery and caesarean section with decision tree model

Fatemeh Mirparsa; Abasat Mirzaei; Khalil Alimohammadzadeh

doi:10.53730/ijhs.v6nS7.13402

Authors

Fatemeh Mirparsa Midwifery Graduate and Masters Student of Health Care Management, Department of Health Care Management, Faculty of Health , Tehran, Medical Sciences, Islamic Azad University, Tehran, Iran
Abasat Mirzaei Associate Professor, Department of Health Care Management, Faculty of Health, Tehran, Medical Sciences, Islamic Azad University, Tehran, Iran Associate Professor, Health Economic Policy Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
Khalil Alimohammadzadeh
amacademic@yahoo.com
Department of Health Services Management,School of Management, North Tehran Branch, Islamic Azad University, Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran

Keywords:

Cost - desirability, natural delivery, caesarean section, decision tree model

Abstract

Objective: This article deals with the cost-benefit analysis of natural childbirth and caesarean section with decision tree model.

Methods: This is a practical study in which 644 cases of natural and cesarean births (including 317 natural births and 327 cesarean births) were extracted and included in the relevant list. Then mothers who had been at least 3 months after giving birth were included in the study. The data was collected using the researcher's checklist and EQ-5D-3L structured questionnaire by the researcher. SPSS 26 and R Core Team (2021) software were used to perform the analysis. Results: Natural childbirth was more prevalent for pregnant women compared to cesarean delivery. which had a lower cost (26980930.90±16603206.35 Rials vs. 48883938.59 ± 6126709.15 Rials) and better utility (86.91± 4.353vs. 64.16±7.348) for all evaluated outcomes. Conclusions: It is necessary to control and manage cesarean section in cases without clinical indication. Also, other low-cost and easy-to-access strategies should be carried out for the awareness of mothers and cultural and legal foundation in the field of promoting natural childbirth.

Downloads

Download data is not yet available.

References

Boerma T, Ronsmans C, Melesse DY, Barros AJD, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341-8.

Shirzad M, Shakibazadeh E, Hajimiri K, Betran AP, Jahanfar S, Bohren MA, et al. Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in Iran: a mixed-methods systematic review. Reproductive Health. 2021;18(1):1-30.

Abbas MS, Askar OA, Aleem AAA. Pre-emptive ketorolac for prevention of intraoperative shoulder pain in patients undergoing cesarean section: A double blind randomized clinical trial. Asian Journal of Anesthesiology. 2017;55(3):68-72.

Gallyamova ZV, Batyukova VE, Malakhova VY, Fomenko EV. Health care system in the USSR (through the example of the Kirov region). J. Adv. Pharm. Educ. Res| Oct-Dec. 2019;9(4):70-75.

Faller EM, Hernandez MT, Hernandez AM, Gabriel JR. Emerging Roles of Pharmacist in Global Health: An Exploratory Study on their Knowledge, Perception and Competency. Arch. Pharm. Pract. 2020 Jan 1;11(1): 40-6

Rezapour A, Moradpour A, Panahi S, Javan-Noughabi J, Vahedi S. Health economic evaluation in Iran (1998–2017), a bibliometrics analysis. Int. J. Pharm. Phytopharmacol. Res.. 2020;10(4):95-102.

Pourshirazi M, Heidarzadeh M, Taheri M, Esmaily H, Babaey F, Talkhi N, et al. Cesarean delivery in Iran: a population-based analysis using the Robson classification system. BMC Pregnancy Childbirth. 2022;22(1):185.

Rafiei M, Saei Ghare M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed. 2018;16(4):221-34.

Gomaa K, Abdelraheim AR, El Gelany S, Khalifa EM, Yousef AM, Hassan H. Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study. BMC Pregnancy Childbirth. 2021;21(1):634.

Rahmawati S, Graber MA, Hakimi M, Multi AG, Bastian I, Rahman N. Cost Comparison of Emergency Cesarean Section in Indonesia: The impact of Australian Model of Diagnosis-related Groups as a Payment System for Patient Care in Hospitals. Open Access Macedonian Journal of Medical Sciences. 2021;9(E):216-23.

Curcio D, Cane A, Fernández F, Correa J. Surgical site infection in elective clean and clean-contaminated surgeries in developing countries. Int J Infect Dis. 2019;80:34-45.

Negrini R, da Silva Ferreira RD, Guimarães DZ. Value-based care in obstetrics: comparison between vaginal birth and caesarean section. BMC Pregnancy Childbirth. 2021;21(1):333.

Yaghoubi M, Javadi M, Karimi S, Pirasteh V. Costs of normal and caesarian section delivery before and after implementation of the national health sector evolution plan in Iran from the perspectives of patients, health service providers and hospitals. Journal of School of Public Health and Institute of Public Health Research. 2018;16(2):114-25.

Ardakani ZB, Navabakhsh M, Ranjbar F, Tremayne S, Akhondi MM, Tabrizi AM. Dramatic rise in cesarean birth in Iran: A coalition of private medical practices and womenâ s choices. International Journal of Women's Health and Reproduction Sciences. 2020;8(3):245-58.

Nouraei Motlagh S, Asadi-piri Z, Bajoulvand R, Seyed Mohseni F, Bakhtiar K, Birjandi M, et al. Factors contributing to Iranian pregnant Women’s tendency to choice cesarean section. Medical-Surgical Nursing Journal. 2020;9(2).

Mousavi SR, Amiri-Farahani L, Hasanpoor-Azghady SB, Saravi SO. Comparing the effect of in-person and virtual childbirth preparation trainings on the fear of childbirth (FOC) and pregnancy experience of pregnant women: protocol for a quasi-experimental feasibility study. Pilot Feasibility Stud. 2021;7(1):194.

Maleki M, Mousavizadeh A, Parhizkar S, Shams M. Using Social Marketing to Reduce Intention of Cesarean Section in Iranian Women. J Pregnancy. 2021;2021:3920126.

Bahmaei J, Maleki A. Evaluation of the Effect of Health Sector Evolution Plan on the Rate of Cesarean Sections in Hospitals Affiliated to Abadan School of Medical Sciences. Journal of health research in community. 2019;5(3):52-60.

Zamani-Alavijeh F, Araban M, Hassanzadeh A, Makhouli K. Contributing factors of pregnant women's beliefs towards mode of delivery: a cross-sectional study from Iran. Matern Health Neonatol Perinatol. 2018;4:9.

Raoofi S, khosravizadeh O, Ahadinezhad B, Khan Mohammadi S, Arefi S, Shahsavari S. Effect of health transformation plan on natural childbirth and cesarean section indicators: An Interrupted Time Series Analysis in a Private Hospital of Tehran. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2020;23(5):51-9.

Afshari M, Pourmotahar M, Qavami Azad Z, Corani Bahador R, Radin Manesh M. The Impact of the Health Care Reform Plan on the Rate of Caesarean Section in the Educational Hospital: A Case Study. Evidence Based Health Policy, Management & Economics. 2018;2(1):12-9.

Moslehi S, Kazemnejad A, Mohaddesi H, Karimi H. Determination of a 12-year trend of cesarean surgery and vaginal delivery in West Azerbaijan Province of Iran and its prediction until 2018. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(6):71-9.

Khan MN, Kabir MA, Shariff AA, Rahman MM. Too many yet too few caesarean section deliveries in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys data. PLOS Global Public Health. 2022;2(2):e0000091.

Alhassan A. Prevalence and socioeconomic predictive factors of cesarean section delivery in Ghana. Menoufia Medical Journal. 2022;35(1):190-5.

Roy N, Mishra PK, Mishra VK, Chattu VK, Varandani S, Batham SK. Changing scenario of C-section delivery in India: Understanding the maternal health concern and its associated predictors. J Family Med Prim Care. 2021;10(11):4182-8.

Mojtabaeian M GMV, Hosseini N. The effect of health system transformation program on the prevalence and costs of natural childbirth in hospitals in Mashhad. The 3rd National Conference on Organizational Innovation and Development with the Approach of the Islamic Model of Iran; Mashad: 2019; 2019.

Hamed Zandian, Sogand Tourani, Farideh Moradi, Telma Zahirian Moghadam. Effect of Health Sector Evolution Plan on the Prevalence and costs of Caesarean section and natural childbirth. Health Monitor Journal of the Iranian Institute for Health Sciences Research. 2017;16(4):411-9.

Binyaruka P, Mori AT. Economic consequences of caesarean section delivery: evidence from a household survey in Tanzania. BMC Health Services Research. 2021;21(1):1367.

Entringer AP, Pinto M, Gomes M. Cost-effectiveness analysis of natural birth and elective C-section in supplemental health. Rev Saude Publica. 2018;52:91.

Chen H, Tan D. Cesarean Section or Natural Childbirth? Cesarean Birth May Damage Your Health. Front Psychol. 2019;10:351.

Mahmodiyan A, Kazemi S, Ghojazade M. Comparison of Sexual problems during the first 6 month after normal vaginal delivery and cesarean in nulliparous women referred to health centers of Ramsar in 2014-2015. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20(5):7-14.