Costs of publicly provided maternity services in Rosario, Argentina.
OBJECTIVE
This study estimates the costs of maternal health services in Rosario, Argentina.


METHODS
The provider costs (US$ 1999) of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre.


RESULTS
The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57) is five times greater than that of a normal vaginal delivery ($105.61). A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time.


CONCLUSIONS
These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.
Borghi
Josephine
J
Health Policy Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT. jo.Borghi@lshtm.ac.uk
Bastus
Silvia
S
Belizan
María
M
Carroli
Guillermo
G
Hutton
Guy
G
Fox-Rushby
Julia
J
D001118:Argentina; D002585:Cesarean Section / Q000191:economics; D003151:Community Health Centers / Q000191:economics*; D036861:Delivery, Obstetric / Q000191:economics; D004180:Direct Service Costs; D005260:Female; D017048:Health Care Costs; D017721:Hospital Costs; D006773:Hospitals, Municipal / Q000191:economics*; D006801:Humans; D008427:Maternal Health Services / Q000191:economics* / Q000458:organization & administration; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics; D011632:Public Assistance / Q000706:statistics & numerical data*