Ibrahim, Wan Norlida
A cost-effective analysis of intrapartum care for low risk mothers at two different levels of care in Jeli, Kelantan.
A cost-effective analysis of intrapartum care for low risk mothers at two different levels of care in Jeli, Kelantan..
(Submitted)
Abstract
A study of the cost-effectiveness of intrapartum care for the low risk antenatal mother was
undertaken at two different levels of care in Kelantan. Cases were selected from J eli
alternative birthing center (ABC) (community-based center) and the respective{ district
hospital, Tanah Merah Hospital (hospital-based center) for one year startingfrom 1st
January until 31 st December 2001. Cost analysis was conducted from provider and patient
perspectives. The research team used effective intrapartum care as the outcome measure.
The criteria for the effective intrapartum care are based on normal clinical outcome and
maternal satisfaction. A total of 117 low risk antenatal mother were recruited in the study,
58 and 59 low risk antenatal mothers from community-based and hospital-based center
respectively.
Results: The marginal means of provider cost, patient cost and societal cost differed
significantly (p<0.001) between Jeli ABC and Tanah Merah hospital for intrapartum care of
low risk antenatal mother. The marginal mean provider costs were RM 390.55 and RM
521.93 per case for Jeli ABC and Tanah Merah hospital respectively. The marginal mean
patient costs were RM110.32 and RM256.81 per case for ABC Jeli and Tanah Merah
hospital respectively. The marginal mean societal costs were RM541 .59 and RM per case
for ABC intrapartum care and Tanah Merah hospital respectively. Jeli ABC was five times
more effective (OR 5.17, CI: 2.010,13.304). The cost-effectiveness ratios ofRM138.00 and
RM323.90 per unit outcome for Jeli ABC and Tanah Merah hospital respectively were
significantly different (p<0.001).
Conclusion: The study found that Jeli alternative birthing center level (community-based
center) is less expensive than Tanah Merah hospital (hospital-based center) in providing
intrapartum care for low risk mothers. The center also has a better clinical outcome and
higher satisfaction than Tanab Merah hospital therefore Jeli ABC is more effective in
providing intrapartum care for low risk mother than Tanah Merah hospital. Jeli ABC is also
more cost-effectiveness compared to Tanah Merah hospital.
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