Economic implications of reducing caesarean section rates – Analysis of two health systems
Patrick Moran, Charles Normand, Patricia Mackin (now Gillen), Francesca Wuytack, Michael Turner, Cecily Begley, Deirdre Daly
Caesarean section (CS) rates throughout Europe have risen significantly over the last two decades. As well as being an important clinical issue, these changes in mode of birth may have substantial resource implications. Policy initiatives to curb this rise have had to contend with the multiplier effect of women who had a CS for their first birth having a greater likelihood of requiring one during subsequent births, thus making it difficult to decrease CS rates in the short term. Our study examines the long-term resource implications of reducing CS rates among first-time mothers, as well as improving rates of vaginal birth after caesarean section (VBAC), among an annual cohort of women over the course of their most active childbearing years (18 to 44 years) in two public health systems in Europe. We found that the economic benefit of improvements in these two outcomes is considerable, with the net present value of the savings associated with a five-percentage-point change in nulliparous CS rates and VBAC rates being €1.1million and £9.8million per annual cohort of 18-year-olds in Ireland and England/Wales, respectively. Reductions in CS rates among first-time mothers are associated with a greater payoff than comparable increases in VBAC rates. The net present value of achieving CS rates comparable to those currently observed in the best performing Scandinavian countries was €3.5M and £23.0M per annual cohort in Ireland and England/Wales, respectively.
Published - 28 Jul 2020
10.1371/journal.pone.0228309Licence: CC BY
Moran_et_al_2020_Economic_implications_of_CS_Accepted_version (1)Accepted author manuscript, 208 KBLicence: CC BY
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Cesarean Section Medicine & Life Sciences 100%
Economics Medicine & Life Sciences 81%
Health Medicine & Life Sciences 51%
Vaginal Birth after Cesarean Medicine & Life Sciences 48%
Wales Medicine & Life Sciences 24%
Ireland Medicine & Life Sciences 24%
England Medicine & Life Sciences 20%
Parturition Medicine & Life Sciences 14%
Moran, P., Normand, C., Mackin (now Gillen), P., Wuytack, F., Turner, M., Begley, C., & Daly, D. (2020). Economic implications of reducing caesarean section rates – Analysis of two health systems. PLoS ONE, 15(7), e0228309. [e0228309]. https://doi.org/10.1371/journal.pone.0228309
Moran, Patrick ; Normand, Charles ; Mackin (now Gillen), Patricia ; Wuytack, Francesca ; Turner, Michael ; Begley, Cecily ; Daly, Deirdre. / Economic implications of reducing caesarean section rates – Analysis of two health systems. In: PLoS ONE. 2020 ; Vol. 15, No. 7. pp. e0228309.
@article{058488224533457aafdeb49273ffbeb1,
title = "Economic implications of reducing caesarean section rates – Analysis of two health systems",
abstract = "Caesarean section (CS) rates throughout Europe have risen significantly over the last two decades. As well as being an important clinical issue, these changes in mode of birth may have substantial resource implications. Policy initiatives to curb this rise have had to contend with the multiplier effect of women who had a CS for their first birth having a greater likelihood of requiring one during subsequent births, thus making it difficult to decrease CS rates in the short term. Our study examines the long-term resource implications of reducing CS rates among first-time mothers, as well as improving rates of vaginal birth after caesarean section (VBAC), among an annual cohort of women over the course of their most active childbearing years (18 to 44 years) in two public health systems in Europe. We found that the economic benefit of improvements in these two outcomes is considerable, with the net present value of the savings associated with a five-percentage-point change in nulliparous CS rates and VBAC rates being €1.1million and £9.8million per annual cohort of 18-year-olds in Ireland and England/Wales, respectively. Reductions in CS rates among first-time mothers are associated with a greater payoff than comparable increases in VBAC rates. The net present value of achieving CS rates comparable to those currently observed in the best performing Scandinavian countries was €3.5M and £23.0M per annual cohort in Ireland and England/Wales, respectively.",
author = "Patrick Moran and Charles Normand and {Mackin (now Gillen)}, Patricia and Francesca Wuytack and Michael Turner and Cecily Begley and Deirdre Daly",
pages = "e0228309",
publisher = "PLoS",
Moran, P, Normand, C, Mackin (now Gillen), P, Wuytack, F, Turner, M, Begley, C & Daly, D 2020, 'Economic implications of reducing caesarean section rates – Analysis of two health systems', PLoS ONE, vol. 15, no. 7, e0228309, pp. e0228309. https://doi.org/10.1371/journal.pone.0228309
Economic implications of reducing caesarean section rates – Analysis of two health systems. / Moran, Patrick ; Normand, Charles; Mackin (now Gillen), Patricia; Wuytack, Francesca; Turner, Michael; Begley, Cecily; Daly, Deirdre.
In: PLoS ONE, Vol. 15, No. 7, e0228309, 28.07.2020, p. e0228309.
T1 - Economic implications of reducing caesarean section rates – Analysis of two health systems
AU - Moran, Patrick
AU - Normand, Charles
AU - Mackin (now Gillen), Patricia
AU - Wuytack, Francesca
AU - Turner, Michael
AU - Begley, Cecily
AU - Daly, Deirdre
N2 - Caesarean section (CS) rates throughout Europe have risen significantly over the last two decades. As well as being an important clinical issue, these changes in mode of birth may have substantial resource implications. Policy initiatives to curb this rise have had to contend with the multiplier effect of women who had a CS for their first birth having a greater likelihood of requiring one during subsequent births, thus making it difficult to decrease CS rates in the short term. Our study examines the long-term resource implications of reducing CS rates among first-time mothers, as well as improving rates of vaginal birth after caesarean section (VBAC), among an annual cohort of women over the course of their most active childbearing years (18 to 44 years) in two public health systems in Europe. We found that the economic benefit of improvements in these two outcomes is considerable, with the net present value of the savings associated with a five-percentage-point change in nulliparous CS rates and VBAC rates being €1.1million and £9.8million per annual cohort of 18-year-olds in Ireland and England/Wales, respectively. Reductions in CS rates among first-time mothers are associated with a greater payoff than comparable increases in VBAC rates. The net present value of achieving CS rates comparable to those currently observed in the best performing Scandinavian countries was €3.5M and £23.0M per annual cohort in Ireland and England/Wales, respectively.
AB - Caesarean section (CS) rates throughout Europe have risen significantly over the last two decades. As well as being an important clinical issue, these changes in mode of birth may have substantial resource implications. Policy initiatives to curb this rise have had to contend with the multiplier effect of women who had a CS for their first birth having a greater likelihood of requiring one during subsequent births, thus making it difficult to decrease CS rates in the short term. Our study examines the long-term resource implications of reducing CS rates among first-time mothers, as well as improving rates of vaginal birth after caesarean section (VBAC), among an annual cohort of women over the course of their most active childbearing years (18 to 44 years) in two public health systems in Europe. We found that the economic benefit of improvements in these two outcomes is considerable, with the net present value of the savings associated with a five-percentage-point change in nulliparous CS rates and VBAC rates being €1.1million and £9.8million per annual cohort of 18-year-olds in Ireland and England/Wales, respectively. Reductions in CS rates among first-time mothers are associated with a greater payoff than comparable increases in VBAC rates. The net present value of achieving CS rates comparable to those currently observed in the best performing Scandinavian countries was €3.5M and £23.0M per annual cohort in Ireland and England/Wales, respectively.
UR - https://pure.ulster.ac.uk/en/publications/economic-implications-of-reducing-caesarean-section-rates-analysi
UR - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0228309
SP - e0228309
Moran P, Normand C, Mackin (now Gillen) P, Wuytack F, Turner M, Begley C et al. Economic implications of reducing caesarean section rates – Analysis of two health systems. PLoS ONE. 2020 Jul 28;15(7):e0228309. e0228309. https://doi.org/10.1371/journal.pone.0228309