ACTIVE MANAGEMENT OF LABOUR
What is the active management of labour?
West J Med.
2000 Apr;172(4):240-3.
Active management of labor: a cost analysis
of a randomized controlled trial.
Department of Obstetrics and Gynecology, University of New Mexico Health
Sciences Center, Albuquerque 87131, USA. rrogers@obgyn.unm.edu
To compare the costs of a protocol of active management of labor
with those of traditional labor management. Cost analysis of a
randomized controlled trial. From August 1992 to April 1996, we
randomly allocated 405 women whose infants were delivered at the University
of New Mexico Health Sciences Center, Albuquerque, to an active management
of labor protocol that had substantially reduced the duration of labor or a
control protocol. We calculated the average cost for each delivery, using
both actual costs and charges. The reduced duration of labor by active management did not
translate into significant cost savings. Overall, an average cost saving of
only $47.91, or 2%, was achieved for labors that were actively managed. This
reduction in cost was due to a decrease in the rate of cesarean sections in
women whose labor was actively managed and not to a decreased duration of
labor.
Objectives:
Design:
Methods:
Results:
The average cost for women assigned
to the active management protocol was $2,480.79 compared with an average
cost of $2,528.61 for women in the control group (P = 0.55). For women whose
infant was delivered by cesarean section, the average cost was $4,771.54 for
active management of labor and $4,468.89 for the control protocol (P =
0.16). Spontaneous vaginal deliveries cost an average of $27.00 more for
actively managed patients compared with the cost for the control protocol.
Conclusions:
