Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104319

Heidi Bart Johnston, PhD, Reproductive Health Consultant, House 2C, Road 73G, Gulshan 2, Dhaka, Bangladesh, Maria Gallo, MSPH, Research and Evaluation, Ipas, 300 Market St, Suite 200, Chapel Hill, NC 27716, 919-760-5716, gallom@ipas.org, and Janie Benson, DrPH, Research and Evaluation Unit, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516.

Background: Treating complications of unsafe abortion can be extremely costly for health systems. Interventions to reduce costs and improve the availability and quality of abortion care in public health systems are known, but implementation has lagged. Comparative cost data could assist policymakers in introducing reforms.

Methods: We created “SAVINGS,” a computer-based tool to enable policymakers to estimate and compare the health system costs of abortion care. We then identified four archetypes of policy and services delivery and, using cost data primarily from Uganda, show how per-case costs are affected by the assumptions within each scenario.

Results: The mean cost per abortion-care case was $46 within a setting that placed heavy restrictions on elective abortion and used an ad hoc approach to service delivery focused mainly on treating abortion complications at the tertiary care level; $26 within a restrictive legal setting that used preferred interventions for treating complications by mid-level providers; $34 within a liberal legal setting that allowed elective abortion while relying on an ad hoc approach to service delivery; and $5 within a liberal legal setting that offered elective abortion care using preferred interventions, including at the primary care level.

Discussion: Abortion-related care using preferred technical interventions substantially reduced health care system costs regardless of the legal setting. The greatest reduction in costs (90%) occurred when preferred interventions were used within a liberal legal setting rather than a restricted setting using ad hoc interventions.

Learning Objectives: At the end of the session, participants will be able to do the following two objectives

• To describe Savings, a computer-based tool for estimating the health system costs of abortion care; and
• To describe the relative health system costs of abortion-related care under four archetypical policy and service delivery scenarios.

Keywords: Abortion, Cost Issues

Related Web page: www.ipas.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation