TY - JOUR
T1 - Medical abortion and manual vacuum aspiration for legal abortion protect women's health and reduce costs to the health system
T2 - Findings from Colombia
AU - Rodriguez, Maria Isabel
AU - Mendoza, Willis Simancas
AU - Guerra-Palacio, Camilo
AU - Guzman, Nelson Alvis
AU - Tolosa, Jorge E.
N1 - Publisher Copyright:
© 2015 Reproductive Health Matters.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - The majority of abortions in Colombia continue to take place outside the formal health system under a range of conditions, with the majority of women obtaining misoprostol from a thriving black market for the drug and self-administering the medication. We conducted a cost analysis to compare the costs to the health system of three approaches to the provision of abortion care in Colombia: post-abortion care for complications of unsafe abortions, and for legal abortions in a health facility, misoprostol-only medical abortion and vacuum aspiration abortion. Hospital billing records from three institutions, two large maternity hospitals and one specialist reproductive health clinic, were analysed for procedure and complication rates, and costs by diagnosis. The majority of visits (94%) were to the two hospitals for post-abortion care; the other 6% were for legal abortions. Only one minor complication was found among the women having legal abortions, a complication rate of less than 1%. Among the women presenting for post-abortion care, 5% had complications during their treatment, mainly from infection or haemorrhage. Legal abortions were associated not only with far fewer complications for women, but also lower costs for the health system than for post-abortion care. We calculated based on our findings that for every 1,000 women receiving post-abortion care instead of a legal abortion within the health system, 16 women experienced avoidable complications, and the health system spent US $48,000 managing them. Increasing women's access to safe abortion care would not only reduce complications for women, but would also be a cost-saving strategy for the health system.
AB - The majority of abortions in Colombia continue to take place outside the formal health system under a range of conditions, with the majority of women obtaining misoprostol from a thriving black market for the drug and self-administering the medication. We conducted a cost analysis to compare the costs to the health system of three approaches to the provision of abortion care in Colombia: post-abortion care for complications of unsafe abortions, and for legal abortions in a health facility, misoprostol-only medical abortion and vacuum aspiration abortion. Hospital billing records from three institutions, two large maternity hospitals and one specialist reproductive health clinic, were analysed for procedure and complication rates, and costs by diagnosis. The majority of visits (94%) were to the two hospitals for post-abortion care; the other 6% were for legal abortions. Only one minor complication was found among the women having legal abortions, a complication rate of less than 1%. Among the women presenting for post-abortion care, 5% had complications during their treatment, mainly from infection or haemorrhage. Legal abortions were associated not only with far fewer complications for women, but also lower costs for the health system than for post-abortion care. We calculated based on our findings that for every 1,000 women receiving post-abortion care instead of a legal abortion within the health system, 16 women experienced avoidable complications, and the health system spent US $48,000 managing them. Increasing women's access to safe abortion care would not only reduce complications for women, but would also be a cost-saving strategy for the health system.
KW - Colombia
KW - Decision analysis
KW - Dilatation & curettage (D&C)
KW - Health care costs
KW - Medical abortion
KW - Post-abortion care
KW - Unsafe abortion
KW - Vacuum aspiration abortion
UR - http://www.scopus.com/inward/record.url?scp=84924990203&partnerID=8YFLogxK
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U2 - 10.1016/S0968-8080(14)43788-1
DO - 10.1016/S0968-8080(14)43788-1
M3 - Article
C2 - 25702076
AN - SCOPUS:84924990203
SN - 0968-8080
VL - 22
SP - 125
EP - 133
JO - Reproductive Health Matters
JF - Reproductive Health Matters
IS - 44
ER -