Opportunities for Cost Reduction of Medical Care: Part 3

Monte Malach; William J. Baumol


J Community Health. 2012;37(4):888-896. 

In This Article

Obstetrics and Gynecology

In the United States in 2007, C-Section deliveries accounted for 32% of 1.4 million deliveries.[51] The significant increase in Cesarean Section (C-Section) births has, in part, been related to patient and doctor convenience and malpractice concerns. This is especially true of second pregnancies in patients who had C-Sections for their first pregnancies. However, C-Sections are major surgeries and cost much more than vaginal delivery. Moreover, C-Sections can have detrimental effects on both the mother and the infant, such as subsequent uterine rupture and placental abnormality. Guidelines from the American College of Obstetrics and Gynecology have cautioned against using elective Cesarean delivery before 39 weeks, in order to protect the mother and prevent severe complications in the infant.[52]

Finally, breast cancer recurrence and death has been reduced after 5 years of Tamoxifen® therapy in a 15-year follow-up.[53] Examestane (Aromasin®) therapy has reduced the occurrence of breast cancer in post-menopausal women,[54] thereby improving outcomes for patients and reducing the costs associated with treating breast cancer.


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