TY - JOUR
T1 - Elective induction
T2 - An analysis of economic and health consequences
AU - Kaufman, Karen E.
AU - Bailit, Jennifer L.
AU - Grobman, William
PY - 2002/10
Y1 - 2002/10
N2 - OBJECTIVE: Our purpose was to assess economic and health consequences of elective induction at term. STUDY DESIGN: A decision-tree model incorporating a Markov analysis was used to compare the decision either to electively induce labor at term or expectantly manage the pregnancy until 42 weeks' gestation. Main outcome measures, stratified by parity, cervical ripeness, and gestational age at induction, were number of cesarean deliveries and costs to the health care system. RESULTS: By use of baseline estimates, induction at any gestational age, regardless of parity and cervical ripeness, required expenditures from the medical system. Although never cost saving, inductions were less expensive at later gestational ages, for multiparous patients, and for those women with a favorable cervix. Sensitivity analysis demonstrated a robust model. CONCLUSIONS: Elective induction of labor at term is not cost saving and results in a large excess of cesarean deliveries. Costs are significantly altered by the timing of the induction, parity, and cervical ripeness.
AB - OBJECTIVE: Our purpose was to assess economic and health consequences of elective induction at term. STUDY DESIGN: A decision-tree model incorporating a Markov analysis was used to compare the decision either to electively induce labor at term or expectantly manage the pregnancy until 42 weeks' gestation. Main outcome measures, stratified by parity, cervical ripeness, and gestational age at induction, were number of cesarean deliveries and costs to the health care system. RESULTS: By use of baseline estimates, induction at any gestational age, regardless of parity and cervical ripeness, required expenditures from the medical system. Although never cost saving, inductions were less expensive at later gestational ages, for multiparous patients, and for those women with a favorable cervix. Sensitivity analysis demonstrated a robust model. CONCLUSIONS: Elective induction of labor at term is not cost saving and results in a large excess of cesarean deliveries. Costs are significantly altered by the timing of the induction, parity, and cervical ripeness.
KW - Cesarean delivery
KW - Cost
KW - Decision analysis
KW - Induction of labor
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U2 - 10.1067/mob.2002.127147
DO - 10.1067/mob.2002.127147
M3 - Article
C2 - 12388964
AN - SCOPUS:0036794736
VL - 187
SP - 858
EP - 863
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 4
ER -