The Economic Burden of Abortion and Its Complication Treatment Cares: A Systematic Review

  • Maryam Soleimani Movahed ORCID Department of Health Economics, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
  • Saeed Husseini Barghazan Mail Department of Health Economics, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
  • Fariba Askari Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
  • Morteza Arab Zozani Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
Keywords:
Abortion, Miscarriage, Cost of Illness, Economic Burden of Disease, Review

Abstract

Objective: Abortion related procedures contribute to a significant economic burden because it resulted in prolonged hospital stays for patients. We aimed to gather available evidence on the economic burden of abortion and post-abortion complication treatment cares worldwide.
Materials and methods: PubMed, Web of Science, Scopus, and Embase databases were searched through November 2019. Two researchers independently conducted the quality assessment and data extraction process. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2016 $US).
Results: Totally, 2082 records were retrieved and 32 studies were deemed eligible for qualitative synthesis. The mean total costs per patient with abortion or post-abortion care ranged from $23 to $564. The annual costs ranged from 189,000 $US to 134 million $US.
Conclusion: Abortion and post-abortion care impose a substantial economic burden on society. Understanding the burdensome of abortion or pregnancy termination among policymakers provides vital information and enables informed decisions to be made to establish health care priorities and allocating scarce resources.

References

1. Cahill N, Sonneveldt E, Stover J, Weinberger M, Williamson J, Wei C, et al. A Probabilistic Assessment of Trends in Modern Contraceptive Prevalence, Unmet Need for and Demand Satisfied with Modern methods
in the Countries of the FP2020 initiative 2018.
2. Wulf D. Sharing responsibility: women society and abortion worldwide .New York: The Alan Guttmacher Institute 1999.
3. Gerdts C, Tunçalp O, Johnston H, Ganatra B. Measuring abortion-related mortality: challenges and opportunities. Reprod Health 2015;12: 87.
4. Vlassoff M, Shearer J, Walker D, Lucas H. Economic impact of unsafe abortion-related morbidity and mortality: evidence and estimation challenges. Institute of Development Studies BrightonBN1 9RE UK 2008.
5. Calhoun BC. Book Review: Complications: Abortion’s Impact on Women. Linacre Q 2018; 85: 178-9.
6. Gebretsadik A, international g. Factors Associated with Management Outcome of Incomplete Abortion in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia. Obstet Gynecol Int 2018; 2018: 3958681.
7. Katuashi DI, Tshefu AK, Coppieters Y. Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo. Reprod Health 2018;15: 123.
8. Shwe A, Riewpaiboon A, Youngkong S. Treatment cost and costing model of obstetric complications at a hospital in Myanmar. PLoS One. 2019; 14: e0213141
9. Johnston HB, Oliveras E, Akhter S, Walker DG. Health system costs of menstrual regulation and care for abortion complications in Bangladesh. International perspectives on sexual and reproductive health 2010; 36: 197-204.
10. Ismail WNAW, Jasmi N, Khan T, Hong YH, Neoh CF. The Economic Burden of Candidemia and Invasive Candidiasis: A Systematic Review. Value in Health Regional Issues 2020; 21: 53-8.
11. Babigumira JB, Stergachis A, Veenstra DL, Gardner JS, Ngonzi J, Mukasa-Kivunike P, et al. Estimating the costs of induced abortion in Uganda: a model-based analysis. BMC Public Health 2011; 11: 904.
12. Benson J, Gebreselassie H, Mañibo MA, Raisanen K, Johnston HB, Mhango Ch, et al. Costs of postabortion care in public sector health facilities in Malawi: a
cross-sectional survey. BMC Health Services Research 2015; 15: 562.
13. Benson J, Okoh M, KrennHrubec K, Lazzarino MAM, Johnston HB. Public hospital costs of treatment of abortion complications in Nigeria. International Journal of Gynaecology& Obstetrics 2012; 118: S134-S40.
14. Diamond M, Palmore JA, Smith RG, Steinhoff PG. Abortion in Hawaii. Fam Plann Perspect 1973; 1: 54-60.
15. Ilboudo PGC, Greco G, Sundby J, Torsvik G. Estimating the costs for the treatment of abortion complications in two public referral hospitals: a cross-sectional study in Ouagadougou, Burkina Faso. BMC Health Serv Res 2016; 16: 559.
16. Johnston HB, Gallo MF, Benson J. Reducing the costs to health systems of unsafe abortion: a comparison of four strategies. J Fam Plann Reprod Health Care 2007; 33: 250–57.
17. Kay BJ, Katzenellenbogen J, Fawcus S, Karim SA. An analysis of the cost of incomplete abortion to the public health sector in South Africa-1994. SAMJ 1997; 87: 442-7.
18. Konje JC, Obisesan KA, Ladipo OA. Health and economic consequences of septic induced abortion. Int J Gynaecol Obstet 1992; 37: 193-7.
19. Levin C, Grossman D, Berdichevsky K, Diaz C, Aracena B, Garcia S, et al. Exploring the costs and economic consequences of unsafe abortion in Mexico City before legalisation. Reproductive Health Matters 2009;17:120-32.
20. Rehan N. Cost of the treatment of complications of unsafe abortion in public hospitals. J Pak Med Assoc 2011;61:169-72.
21. Paul M, Gebreselassie H, Samai M, Benson J, Kargbo S, Lazzarino MM. Unsafe abortion in Sierra Leone: an examination of costs and burden of treatment on healthcare resources. J Womens Health Care 2015; 4: 228-34.
22. Sundaram A, Vlassoff M, Mugisha F, Bankole A, Singh S, Amanya L, et al. Documenting the individual-and household-level cost of unsafe abortion in Uganda. International Perspectives on Sexual and Reproductive Health 2013; 39: 174-84.
23. Vlassoff M, Mugisha F, Sundaram A, Bankole A, Singh S, Amanya L, et al. The health system cost of post-abortion care in Uganda. Health Policy and Planning 2014; 29: 56-66.
24. Vlassoff M, Musange SF, Kalisa IR, Ngabo F, Sayinzoga F, Singh S, et al. The health system cost of post-abortion care in Rwanda. Health Policy and Planning 2015; 30: 223-33.
25. Vlassoff M, Walker D, Shearer J, Newlands D, Singh SJIpos, health r. Estimates of health care system costs of unsafe abortion in Africa and Latin America. International Perspectives on Sexual and Reproductive Health 2009; 35: 114-21.
26. Afable-Munsuz A, Gould H, Stewart F, Phillips KA, Van Bebber SL, Moore CJC. Provider practice models for and costs of delivering medication abortion-evidence from 11 US abortion care settings. Contraception 2007; 75: 45-51.
27. Asante F A, Avotri T S, d’Almeida S A. “Costing of Safe Motherhood (Making Pregnancy Safer) Initiative in Ghana: A Case Study of Wassa West District.” WHO
Regional Office for Africa, Harare, Zimbabwe. 2004.
28. Gold RB, Daley D. Public funding of contraceptive, sterilization and abortion services, fiscal year 1990. Family planning perspectives 1991; 23: 204-11.
29. Hughes J, Ryan M, Hinshaw K, Henshaw R, Rispin R, Templeton A. The costs of treating miscarriage: a comparison of medical and surgical management. BJOG 1996; 103: 1217-21.
30. Jones RK, Upadhyay UD, Weitz TA. At what cost? Payment for abortion care by US women. Womens Health Issues 2013; 23: e173-e8.
31. Nestor B, Gold RB. Public funding of contraceptive, sterilization and abortion services, 1982. Family Planning Perspectives 1984; 16: 128-33.
32. Roberts SCM, Gould H, Kimport K, Weitz TA, Green Foster D. Out-of-pocket costs and insurance coverage for abortion in the United States. Women Health Issues 2014; 24: e211-e18.
33. Van Bebber SL, Phillips KA, Weitz TA, Gould H, Stewart F. Patient costs for medication abortion: Results from a study of five clinical practices. Women Health Issues 2006; 16: 4-13.
34. Ilboudo PGC, Greco G, Sundby J, Torsvik G. Costs and consequences of abortions to women and their households: a cross-sectional study in Ouagadougou, Burkina Faso. Health Policy and Planning 2014; 30: 500-7.
35. Johnson BR, Benson J, Bradley J, Rabago AR. Costs and resource utilization for the treatment of incomplete abortion in Kenya and Mexico. Social Science & Medicine 1993; 36: 1443-53.
36. Leone T, Coast E, Parmar D, Vwalika B. The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion. Health Policy and Planning 2016; 31: 825-33.
37. Parmar D, Leone T, Coast E, Murray SF, Hukin E, Vwalika B. Cost of abortions in Zambia: A comparison of safe abortion and post abortion care. Global Public Health 2017; 12: 236-49.
38. Prada E, Maddow-Zimet I, Juarez F. The cost of postabortion care and legal abortion in Colombia. International Perspectives on Sexual and Reproductive Health 2013; 39: 114-23.
39. Vlassoff M, Fetters T, Kumbi S, Singh S. The health system cost of postabortion care in Ethiopia. International Journal of Gynaecologu & Obstetrics 2012; 118: S127-33.
40. Henshaw SK, Adewole I, Singh S, Bankole A, Oye-Adeniran B, Hussain R. Severity and cost of unsafe abortion complications treated in Nigerian hospitals. International Family Planning Perspectives 2008; 34: 40-50.
41. Facchini L, Dingmann B, Brown K, Hercher L, Cooney C, Bajaj K. Accessibility of Pregnancy Termination: A Pilot Study of Genetic Counselors and Abortion Providers Throughout the United States 2018. Human Genetics Theses and Capstones.
42. Groves P, Kayyali B, Knott D, Kuiken SV. The'big data'revolution in healthcare: Accelerating value and innovation . Center for US Health System Reform Business Technology Office 2013.
Published
2020-10-18
How to Cite
1.
Soleimani Movahed M, Husseini Barghazan S, Askari F, Arab Zozani M. The Economic Burden of Abortion and Its Complication Treatment Cares: A Systematic Review. J Fam Reprod Health. 14(2):60-67.
Section
Review Articles