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Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia
BACKGROUND: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. METHODS: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospita...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506594/ https://www.ncbi.nlm.nih.gov/pubmed/28701153 http://dx.doi.org/10.1186/s12884-017-1403-8 |
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author | Accorsi, Sandro Somigliana, Edgardo Solomon, Hagos Ademe, Tsegaye Woldegebriel, Jofrey Almaz, Biadgo Zemedu, Mohammed Manenti, Fabio Tibebe, Akalu Farese, Pasquale Seifu, Aberra Menozzi, Serena Putoto, Giovanni |
author_facet | Accorsi, Sandro Somigliana, Edgardo Solomon, Hagos Ademe, Tsegaye Woldegebriel, Jofrey Almaz, Biadgo Zemedu, Mohammed Manenti, Fabio Tibebe, Akalu Farese, Pasquale Seifu, Aberra Menozzi, Serena Putoto, Giovanni |
author_sort | Accorsi, Sandro |
collection | PubMed |
description | BACKGROUND: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. METHODS: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospital with the ambulance were consecutively evaluated during a three-months period. The health professionals who managed the referred cases were requested to identify those that could be considered as undoubtedly effective. Pre and post-referral costs included those required to run the ambulance service and the additional costs necessary for the assistance in the hospital. Local life expectancy tables were used to calculate the number of year saved. RESULTS: A total of 111 ambulance referrals were recorded. The ambulance was undoubtedly effective for 9 women and 4 newborns, corresponding to 336 years saved. The total cost of the intervention was 8299 US dollars. The cost per year life saved was 24.7 US dollars which is below the benchmarks of 150 and 30 US dollars that define attractive and very attractive interventions. Sensitivity analyses on the rate of effective referrals, on the costs of the ambulance and on the discount rate confirmed the robustness of the result. CONCLUSIONS: An ambulance-based referral system for EmONC in remote sub-Saharan areas appears highly cost-effective. |
format | Online Article Text |
id | pubmed-5506594 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55065942017-07-12 Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia Accorsi, Sandro Somigliana, Edgardo Solomon, Hagos Ademe, Tsegaye Woldegebriel, Jofrey Almaz, Biadgo Zemedu, Mohammed Manenti, Fabio Tibebe, Akalu Farese, Pasquale Seifu, Aberra Menozzi, Serena Putoto, Giovanni BMC Pregnancy Childbirth Research Article BACKGROUND: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. METHODS: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospital with the ambulance were consecutively evaluated during a three-months period. The health professionals who managed the referred cases were requested to identify those that could be considered as undoubtedly effective. Pre and post-referral costs included those required to run the ambulance service and the additional costs necessary for the assistance in the hospital. Local life expectancy tables were used to calculate the number of year saved. RESULTS: A total of 111 ambulance referrals were recorded. The ambulance was undoubtedly effective for 9 women and 4 newborns, corresponding to 336 years saved. The total cost of the intervention was 8299 US dollars. The cost per year life saved was 24.7 US dollars which is below the benchmarks of 150 and 30 US dollars that define attractive and very attractive interventions. Sensitivity analyses on the rate of effective referrals, on the costs of the ambulance and on the discount rate confirmed the robustness of the result. CONCLUSIONS: An ambulance-based referral system for EmONC in remote sub-Saharan areas appears highly cost-effective. BioMed Central 2017-07-12 /pmc/articles/PMC5506594/ /pubmed/28701153 http://dx.doi.org/10.1186/s12884-017-1403-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Accorsi, Sandro Somigliana, Edgardo Solomon, Hagos Ademe, Tsegaye Woldegebriel, Jofrey Almaz, Biadgo Zemedu, Mohammed Manenti, Fabio Tibebe, Akalu Farese, Pasquale Seifu, Aberra Menozzi, Serena Putoto, Giovanni Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title | Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title_full | Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title_fullStr | Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title_full_unstemmed | Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title_short | Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia |
title_sort | cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural ethiopia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506594/ https://www.ncbi.nlm.nih.gov/pubmed/28701153 http://dx.doi.org/10.1186/s12884-017-1403-8 |
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