The effects of implementing a method to reduce anal sphincter ruptures

• Main Author: Pirhonen, Laura
• Format: Others
• Language: English
• Published: Linnéuniversitetet, Ekonomihögskolan, ELNU 2011
• Subjects: sphincter rupture; impact evaluation; treatment; Economics; Nationalekonomi
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-12188

Aim of the study: The aim of this study was to measure the effects of a specific technique used when assisting vaginal delivery and intended to decrease anal sphincter ruptures. After measuring the effects, the direct costs of a rupture were calculated and finally the cost impact of the intervention was evaluated. Data and model: Data from deliveries before the intervention, from 2004, and after the intervention, from 2008, were used and a pre-test – post-test evaluation design was applied. The dependent variable was the presence or absence of a rupture and because the variable is binary a logit model was used. The independent variables consisted of twelve different factors considered to affect the number of ruptures. When only accounting for ruptures alone 123 of 2900 deliveries resulted in a sphincter ruptures which equals 4.24% of the total amount of deliveries. Results: When not controlling for any of the independent variables, the risk of getting a rupture decreased by 3.8 percentage points when using the method while assisting a delivery. On the other hand, when controlling for all of the independent variables and the use of the method, the risk of getting a rupture decreased by 2.5 percentage points, from 4.24% to 1.74%. Two different models were tested, one with the variable weeks and one without the same variable, due to the presence of correlation in the model. The total cost of ruptures for a year was calculated as $84,429,254 without the implementation of the method and $34,647,854 with the implementation. Total cost savings for society with the implementation of the method would then be $49,677,045. Conclusions: Implementation of the method is highly recommendable for both society and the women involved. Not only does the number of ruptures decrease due to the method but also the costs for society decreases dramatically.