Cost-Effectiveness Analysis of Latent versus Active Labor Hospital Admission for Medically Low-Risk, Term Women

摘要: Objective To assess the outcomes and costs of hospital admission during latent versus active phase labor. Latent labor has been consistently associated with elevated maternal risk for increased interventions, including epidural anesthesia cesarean delivery, longer stay, higher utilization resources. Methods A cost-effectiveness model was built to simulate a theoretic cohort 3.2 million term, medically low-risk women either being admitted in (< 4 cm dilation) or delaying until (≥ 4 cm dilation). Outcomes included use, mode stillbirth, death, care. All probability, cost, utility estimates were derived from literature, total quality-adjusted life years calculated. Sensitivity analyses Monte Carlo simulation used investigate robustness assumptions. Results Delaying would result 672,000 fewer epidurals, 67,232 deliveries, 9.6 deaths our as compared Additionally, results cost savings $694 annually United States. indicated robust within wide range probabilities costs. found that delayed optimal strategy 76.79 percent trials. Conclusion Delaying is dominant strategy, resulting both better lower Issues related clinical translation these findings are explored.