Cost-effectiveness analysis of a quality improvement program to reduce caesarean sections in Brazilian private hospitals: a case study

Table 2 Maternal and neonatal outcomes according to the model of care. Rio de Janeiro, 2017

Maternal and neonatal outcomes	Total (N = 238)		Standard of care model (N = 154)		PPA model of care (N = 84)		p value
Maternal and neonatal outcomes	N	%	n	%	n	%	p value
Maternal outcomes
Type of labor
Spontaneous	89	37.4	33	21.4	56	66.7	< 0.001
Induced	24	10.1	5	3.2	19	22.6
Without labor	125	52.5	116	75.3	9	10.7
Type of birth
Vaginal	70	29.4	13	8.4	57	67.9	< 0.001
Caesarean	168	70.6	141	91.6	27	32.1
Weighted caesarean^a				88.6		31.7
Severe maternal morbidity	5	2.1	4	2.6	1	1.2	0.658
Maternal near miss	1	0.4	1	0.7	0	0.0	1.000
Maternal death	0	–	0	–	0	–
Admission to Intensive Care Unit	5	2.1	5	3.3	0	0.0	0.164
Maternal satisfaction with childbirth care
Clarity of information	219	92.0	143	92.9	76	90.5	0.517
Respect	227	95.4	147	95.5	80	95.2	0.939
Preserved intimacy	231	97.1	151	98.1	80	95.2	0.220
Time available for questions	212	89.1	141	91.6	71	84.5	0.096
Participation in the decision making	217	91.2	144	93.5	73	86.9	0.086
Any type of violence	6	2.5	3	1.9	3	3.6	0.668
Global satisfaction with childbirth care	228	95.8	148	96.1	80	95.2	0.745
Satisfaction with newborn care	228	95.8	145	94.2	83	98.8	0.103
Neonatal outcomes
Birth weight
< 2.500 g	7	3.0	5	3.3	2	2.4	0.225
2500 to 3999 g	218	92.8	144	94.1	74	90.2
≥ 4000 g	10	4.3	4	2.6	6	7.3
Gestational age (weeks)
37 to 38	107	45.0	83	53.9	24	28.6	< 0.001
Spontaneous^b	35	21.1	17	19.3	18	23.1	0.553
Induced	72	35.5	66	48.2	6	9.1	< 0.001
39 to 41	131	55.0	71	46.1	60	71.4	< 0.001
Apgar < 7 in the 5th min of life	2	0.9	1	0.7	1	1.2	1.000
Any neonatal complication	30	12.6	16	10.4	14	16.7	0.163
Admission to NICU	22	9.2	11	7.1	11	13.1	0.130
Neonatal near miss	19	8.0	11	7.1	8	9.5	0.517
Stillbirth	0	–	0	–	0	–
Neonatal death	0	–	0	–	0	–

PPA Adequate Birth Project; NICU Neonatal Intensive Care Unit
^aWeighted proportion of cesarean section using the propensity score. The variables “age”, “years of study”, “initial preference for the type of childbirth” and “risk pregnancy” were used as explanatory variables for the logistic model of the propensity score and the type of model of care as the outcome variable
^bSpontaneous labor or rupture of membranes

ISSN: 1742-4755