Cost of hospital care of women with an obstetric event without complications and with a maternal death in the Republic of Paraguay in the year 2018

Abstract

The objective of this work was to determine the economic cost of caring for women with maternal death, as well as women with an uncomplicated obstetric event in the Republic of Paraguay in 2018. A retrospective study was carried out on data from a secondary source, in a sample of 150 records including 75 of maternal death and 75 of women with an obstetric event without complications; all registered in the Integrated and Integral Networks of Health Services and Death Certificates of the Paraguayan Civil Status Registry. Results: Average age 26.97 ± 7.84; majority under 25 years of age (50.67%); the highest frequencies of maternal death in the 2 extremes of the sample in those aged 20 and under (24.00%) and in those over 30 (45.33%). 66% of the women are from the urban area while 52% of the deceased are from the rural area. Most of them come from health regions with high population density (Central 31.33%, Alto Paraná 24.67%, Itapúa 8.67%). Only 9 women (6%) correspond to the indigenous population of the country (all deceased). Only 6% had medical insurance and only 4% of the deaths were verified by forensic personnel. In the puerperium were the majority of deaths (62%), the low registration of the situation calls into question the quality of filling out the death certificate. In 90% the attention was in the third level of health, 6.67% at home, journey or the street. In both groups, the cesarean section was mainly the way to interrupt the pregnancy and it can be seen that low education is linked to poor results such as the death of the mother. Conclusion: we see that all cases can be considered preventable, if we add the main pillar, such as family planning, to the priority of quality care, especially considering that one of the leading causes of MM in the country continues to be abortion reflecting the lack of access and coverage of the system as one of the weaknesses to take into account, including the lack of education and access to truthful and timely information by the user.