Abstract

MONCADA VEGA, Gladys; LLANOS-ZAVALAGA, Fernando  and  MAYCA PEREZ, Julio. Direct cost of cesarean sections and reimbursement of health insurance (Seguro Integral de Salud): The case of Hospital de Apoyo Pomabamba, Ancash, Perú.. Rev Med Hered [online]. 2009, vol.20, n.1, pp.4-10. ISSN 1018-130X.

Objective: To determine the direct cost of cesarean section and the rate of reimbursement by health insurance (Seguro Integral de Salud) in Hospital de Apoyo de Pomabamba (HAP), at Ancash. Material and methods: Costing study, retrospective cross-sectional study transversal. All caesarean sections during the period January and December 2003. Were included, 39 were non-complicated and 12 complicated. We reviewed clinical and surgical records of each patient. A univariate analysis including central and dispersion measures was done. Results: Mean age of patients was 25.57 years (range: 16-43 years), cesarean section rate during the period was 5.9%. Total amount billed at HAP during the period was 17 633,30 Peruvian Nuevos Soles (media: 345,75 Peruvian Nuevos Soles).Direct costs of non complicated and complicated caesarean section was 307,64 Peruvian Nuevos Soles and 469,61 Peruvian Nuevos Soles. 52,65% higher direct costs in complicated cases was related to drugs prescribed and length of stay. Conclusions: Percentage assumed by HAP for cesarean sections that should be reimbursed by SIS was 36.5% (6 435,30 Peruvian Nuevos Soles ). Estimated direct costs at HAP cannot be generalize to other public hospitals, due to differences in infrastructure and clinical practices. Further national costs studies are needed to estimate financial gaps at the public Insurance Peruvian System.(Rev Med Hered 2009;20:4-10).

Keywords : Costs; cesarean section; health insurance.

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