@misc{10481/112731,
year = {2018},
month = {5},
url = {https://hdl.handle.net/10481/112731},
abstract = {Introduction
audits of indications for cesarean section (CS), feedback for health professionals, and implementation of best practices, as compared with usual care (QUARISMA study), resulted in a small reduction in the rate of CS in Quebec and important cost savings from a health care payer perspective. Determining the budget impact would enable estimation of the financial consequences if the program is extended nationwide.
Material and methods
a retrospective pre-post study design was used to estimate cost prior to and after the implementation of QUARISMA in Quebec (105,351 subjects). A prospective analysis was performed to measure the budget impact in Canada’s provinces. The primary analytic perspective was that of the Minister of Health, for a 4-year time horizon. Data were taken from the trial for Quebec and extrapolated to Canada’s provinces. A sensitivity analysis was conducted by varying more than one probability at a time.
Findings
over 4 years, there was a decrease of more than $7.8 million in CS burden in Quebec, $11.9 million in vaginal birth and $9.8 million for neonatal complications. The impact on high-risk women was lower than that on low-risk. In years 1 and 2, the provinces would have to cover the cost of program implementation.
Conclusions
QUARISMA led to savings of $27 million in Quebec over 4 years. In the short to medium term, extending the QUARISMA program nationwide could lead to savings of $150.5 million.},
organization = {Canadian Institutes of Health Research (200702MCT−171307-RFA-CFCF−153236, MOP 81275)},
organization = {Spanish Ministry of Health and Consumer Affairs (FIS Exp. PI13/01340)},
publisher = {Elsevier},
keywords = {Caesarean section},
keywords = {Clinical practice guidelines},
keywords = {Budget impact analysis},
title = {Budget impact of a program for safely reducing caesarean sections in Canada},
doi = {10.1016/j.midw.2018.01.022},
author = {Bermúdez Tamayo, Clara and Johri, Mira and Chaillet, Nils},
}