title: An exploratory study of the costs and consequences of prenatal care in the Family Health Program.
abstract: OBJECTIVE
  To assess costs and consequences of prenatal care on perinatal morbidity and mortality.
  
  
  METHODS
  Evaluation study using two types of analysis: implementation and efficiency analysis, carried out at 11 Family Health Units in the Recife, Northeastern Brazil, in 2006. The costs were calculated by means of the activity-based costing technique and the cost-effectiveness ratio was calculated for each consequence. Data sources were information systems of the Ministry of Health and worksheets of costs provided by the Health Department of Recife and Instituto de Medicina Integral Prof. Fernando Figueira. Healthcare units with implemented or partially implemented prenatal care were compared in terms of their cost-effectiveness and perinatal results.
  
  
  RESULTS
  In 64% of the units, prenatal care was implemented with a mean total cost of R$ 39,226.88 and variation of R$ 3,841,87 to R$ 8,765.02 per healthcare unit. In the units with partially implemented prenatal care (36%), the mean total cost was R$ 30,092.61 (R$ 4,272.12 to R$ 11,774.68). The mean cost per pregnant woman was R$ 196.13 with implemented prenatal care and R$ 150.46 with partially implemented prenatal care. A higher proportion of low birth weight, congenital syphilis, perinatal and fetal deaths was found in the partially implemented group.
  
  
  CONCLUSIONS
  Prenatal care is cost-effective for several studied consequences. The adverse effects measured by the health indicators were lower in the units with implemented prenatal care. The mean cost in the partially implemented group was higher, which suggests a possible waste of resources, as the teams' productivity is insufficient for the installed capacity.
authors: Grupo de Pesquisa de Gestão e Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil. suely@imip.org.br
authors: Suely Arruda
authors: SA
authors: Vidal
authors: Isabella Chagas
authors: IC
authors: Samico
authors: Paulo Germano de
authors: PG
authors: Frias
authors: Zulmira Maria de Araújo
authors: ZM
authors: Hartz
mesh_terms: D001938:Brazil; D003362:Cost-Benefit Analysis; D005192:Family Health; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009313:National Health Programs; D054238:Perinatal Mortality; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*