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Coût total des actes chirurgicaux dans la prise en charge des hémorragies de la délivrance

Abstract : Objective Reduction of maternal mortality is a major priority in the public health domain. One of the main causes of maternal mortality is postpartum haemorrhage. Because economic pressures favour the use of less expensive strategies, it is becoming now critical to know exactly the cost of the surgical procedures involved in the treatment of postpartum haemorrhage, in order to provide future guidelines in Implementing reforms in hospital. Materials and methods Evaluation was made on multiple data collected in the Gynecology-Obstetrics and Central Sterile Supplies departments of a tertiary care Hospital. Analysis of the production costs was made based on the actual costs. The receipts were figured on the basis of applicable reimbursement in France in 2005, taking into account the financial decisions of the producers. Results From January 2004 to December 2005, 262 patients were treated for postpartum hemorrhage and patients files were available for review in 255 cases. Of these, surgery was performed in 52 cases. The costs of surgery in the postpartum care ranged from 275.04 € per manual exploration of the uterine cavity (n = 8), 302.48 € per exploration with valve (n = 26), 601.55 € per vascular ligation (n = 3), 725.53 € per vaginal packing or unpacking (n = 10) to 875.06 € per hysterectomy (n = 5). Cleaning and sterilizing of surgical instruments represented a substantial burden, ranging from 7.5% to 11.4% of the total cost of surgery. Discussion and conclusion The costs of surgery for postpartum haemorrhage have been calculated to provide future guidelines for the directions and follow-up of these activities in light of the T2A-EPRD and poles of activity. The actual costs could be used to determine the bases of one or more French DRGs (PMSI) “postpartum hemorrhage” evolution.
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Submitted on : Tuesday, April 5, 2022 - 11:04:19 AM
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D. Castiel, P.-H. Bréchat, B. Benoît, B. Nguon, E. Gayat, et al.. Coût total des actes chirurgicaux dans la prise en charge des hémorragies de la délivrance. Gynécologie Obstétrique & Fertilité, 2008, 36 (5), pp.507-515. ⟨10.1016/j.gyobfe.2008.03.009⟩. ⟨hal-03630677⟩



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