Costs of Maternal Hemorrhage in California

Maternal hemorrhage is a major public health concern nationally and in California.Early diagnosis and treatment can reduce the significant societal and cost burdens of this condition, as well as prevent some maternal mortality due to maternal hemorrhage. Approximately half a million births occur in California annually, nearly half of which are paid by Medi-Cal. Assessing the magnitude of preventable expenditures due to maternal hemorrhage may aid in the widespread implementation of evidence-based guidelines and a reduction of avoidable expenditures.

This report identifies the probabilities of various forms of maternal hemorrhage and uses these probabilities to develop the likelihood of various maternal and neonatal outcomes given the type of hemorrhage and method of delivery. The authors also developed cost scenarios associated with these outcomes for the mother and the baby using publicly available data from the Medi-Cal, fee‐for‐service fee schedule and reimbursement rates to public hospitals in California. They then estimated the average cost per uncomplicated delivery and the average cost for a delivery complicated by maternal hemorrhage and calculated the overall costs of maternal hemorrhage for the Medi-Cal program. The findings presented in this report are based on conservative estimates of costs and use of resources, and are likely to be the lower-bound estimates of probabilities and costs of maternal hemorrhage.   A related report (see below) examines the costs of maternal hypertensive disorders.   This report was developed with funding from the California Department of Public Health, Maternal, Child and Adolescent Health Division.

 

Publication Authors:

• Nadereh Pourat, PhD
• Ana E. Martinez, MPH
• Jeffrey McCullough
• Kimberly D. Gregory
• Lisa Korst
• Gerald F. Kominski, Ph.D.