Development of a Framework for On-Demand Caesarean Section in Romania

Abstract

Background: Caesarean section rates have continued to trend upward in most countries, including Romania, creating a number of economic challenges. In the public health system, there is no regulation for performing Caesarean sections on demand; it is often done unlawfully, and in private hospitals, it is a real business. Thus, this study aims to investigate the budgetary impact at a hospital level and the profit per procedure by introducing on-demand caesarean sections for a fee. Methods: This study was conducted in one of the largest maternity units in Western Romania—the “Bega” Maternity Clinic of the Timisoara County Emergency Hospital. For the analysis, the difference between a proposed occupancy rate (between 50 and 85%, increasing every 5 percent) and the actual occupancy rate was calculated. Considering that this difference can be used to admit patients to receive Caesarean sections on demand for a fee, the profit that could be obtained during the study period was calculated. Results: It is reported that between 238 (proposed occupancy rate of 50%) and 4683 patients (a proposed occupancy rate of 85%) could have benefited from on-demand caesarean section surgery in 2017–2019. Between RON 419,999 and RON 8,551,636 could be obtained in the 3 years of study by implementing caesarean section against payment. Conclusion: The implementation of a system of on-demand payment for caesarean sections in Romania would bring significant profits to the hospital budget.

Selenium status in term neonates, according to birth weight and gestational age, in relation to maternal hypertensive pathology

“…Noteworthy, C-section rate in Romania (44.1% in 2017) was estimated by the Eurostat as the second highest in the European Union ( 39 ), reaching as high as 80% in private clinics ( 40 ). C-section rates of 60.7% ( 41 ) and 64% ( 42 ) were found in two studies performed in two large maternity hospitals in Romania. It is also acknowledged that nowadays in Romania more women elect C-section delivery regardless of a medical recommendation based on prejudgments, fear, or misbeliefs amplified by low level of medical understanding ( 40 – 42 ).…”

Perioperative Analgesia and Patients’ Satisfaction in Spinal Anesthesia for Cesarean Section: Fentanyl Versus Morphine

“…Eurostat data on the percentage of cesarean births in EU countries in 2017 revealed the highest rates in Cyprus (54.8% of all live births being performed via cesarean section), followed by Romania (44.1%), and Bulgaria (43.1%) [37]. A recent paper by Petre et al reported even higher rates in Romania, ranging from 53.6% to 60.7% [38]. Various factors, both personal and external, contribute to this excessive use of cesarean sections.…”

What do Parents Prefer: State or Private Healthcare?

“…Although patients insured in the state health system pay a monthly contribution from their salary, a significant percentage of them prefer to pay extra to the private health service for certain services (4). The analysis of the data shows that this phenomenon is mainly due to the shorter waiting time in private clinics compared to the state system, the medical services (which are estimated by the patients to be superior in the private environment), the possibility for the patient/legal guardian to choose the doctor (in a private clinic), and the possibility to perform laboratory tests quickly, especially in the private environment compared to the state system.…”