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Induced labor not more expensive to healthcare system than spontaneous labor

The cost increases from other aspects of patient care cancel out the induction-related costs, contradicting long-held assumptions.

Jeff Lagasse, Associate Editor

Expectant parents wait 40 weeks for the arrival of their new baby, but what if labor was induced a week earlier?

Conventional wisdom holds that inducing labor at 39 weeks would be cost-prohibitive to a health system. But the results of a joint study between University of Utah Health and Intermountain Healthcare show inducing labor one week early costs the same as waiting for spontaneous labor.

While inducing labor is never recommended unless there is a health-related medical need, the findings may provide some peace of mind to price-conscious care providers who feel induction is necessary.

The cost increases from other aspects of patient care cancel out the induction-related costs, which surprised researchers, as it contradicts assumptions that have held steady for the past three or more decades.

IMPACT

The study aimed to measure the actual cost differences between inducing labor early and spontaneous, natural labor. The research team used data obtained from the ARRIVE clinical trial, a multicenter study consisting of more than 6,000 low-risk, first-time mothers. The team randomized 1,230 women enrolled in the ARRIVE study; 608 were induced at 39 weeks and 622 experienced spontaneous labor.

The results confirm that the increased cost accrued from women spending more time in the hospital after inducing labor is offset by cost saved from avoiding additional tests, visits and medications later in pregnancy, as well as serious health outcomes, like pre-eclampsia.

Additionally, the researchers found that inducing labor at 39 weeks reduced the rate of Cesarean section in new mothers.

The authors said the findings underscore the importance of clinicians considering cost when making medical decisions.

While the study is focused on Utah hospitals, researchers believe the results are applicable across the country. The hospitals in this study span a cross section of healthcare facilities, both academic and community hospitals, where most deliveries occur across the U.S.

THE TREND

Though the findings may be useful for clinicians, previous research suggest that C-sections in particular come with a risk of surgical site infection, particularly among Medicaid-insured women. Mothers delivering via cesarean section covered by Medicaid had a 1.4 fold increase in infection compared to those covered by private insurance, findings showed.
 

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com