Imperial College London
Dr Alexander Carter

DrAlexanderCarter

Faculty of Medicine, Department of Surgery & Cancer

Honorary Senior Lecturer
 
 
 
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Contact

 

a.w.carter

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Orlovic:2017:10.1136/bmjopen-2016-015463,
author = {Orlovic, M and Carter, AW and Marti, J and Mossialos, E},
doi = {10.1136/bmjopen-2016-015463},
journal = {BMJ Open},
title = {Estimating the incidence and the economic burden of third and fourth-degree obstetric tears in the English NHS: an observational study using propensity score matching},
url = {http://dx.doi.org/10.1136/bmjopen-2016-015463},
volume = {7},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective Obstetric care is a high-risk area in healthcaredelivery, so it is essential to have up-to-date quantitativeevidence in this area to inform policy decisions regardingthese services. In light of this, the objective of this studyis to investigate the incidence and economic burden ofthird and fourth-degree lacerations in the English NationalHealth Service (NHS) using recent national data.Methods We used coded inpatient data from HospitalEpisode Statistics (HES) for the financial years from2010/2011 to 2013/2014 for all females that gave birthduring that period in the English NHS. Using HES, we usedpre-existing safety indicator algorithms to calculate theincidence of third and fourth-degree obstetric tears andemployed a propensity score matching method to estimatethe excess length of stay and economic burden associatedwith these events.Results Observed rates per 1000 inpatient episodes in2010/2011 and 2013/2014, respectively: Patient SafetyIndicator—trauma during vaginal delivery with instrument(PSI 18)=84.16 and 91.24; trauma during vaginaldelivery without instrument (PSI 19)=29.78 and 33.43;trauma during caesarean delivery (PSI 20)=3.61 and4.56. Estimated overall (all PSIs) economic burden for2010/2011=£10.7 million and for 2013/2014=£14.5million, expressed in 2013/2014 prices.Conclusions Despite many initiatives targeting thequality of maternity care in the NHS, the incidence of thirdand fourth-degree lacerations has increased during theobserved period which signals that quality improvementefforts in obstetric care may not be reducing incidencerates. Our conservative estimates of the financial burden ofthese events appear low relative to total NHS expenditurefor these years.
AU  - Orlovic,M
AU  - Carter,AW
AU  - Marti,J
AU  - Mossialos,E
DO  - 10.1136/bmjopen-2016-015463
PY  - 2017///
SN  - 2044-6055
TI  - Estimating the incidence and the economic burden of third and fourth-degree obstetric tears in the English NHS: an observational study using propensity score matching
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2016-015463
UR  - http://hdl.handle.net/10044/1/52721
VL  - 7
ER  -
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