Avoiding Hospital Admission for Rupture of Amniotic Membrane (ROM) screening: Role of at Home/Point of Care Testing [8A]

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Abstract

INTRODUCTION:

Rising health care costs are a major focus today. We examined the costs incurred in pregnant women presenting to a perinatal center to rule out rupture of membranes and the potential savings that would have occurred if this condition 1) could have been assessed at home or 2) inexpensively and quickly at the medical center site where they present.

METHODS:

A WIRB approved, retrospective review of medical records was performed in obstetrical patients presenting to rule out spontaneous rupture of membranes, in order to evaluate potential cost savings by screening at home prior to hospital admission. Hospital billing records and medical records were utilized to assess overall costs, including ancillary testing, incurred.

RESULTS:

Preliminary data indicates that 1) 50% of obstetrical patients presenting at a medical center have intact membranes and sent home undelivered and 2) 25% who are negatively screened come to L&D via the emergency department, increasing overall costs. From 214 records analyzed to date, admissions of women without ruptured membranes cost the health care system $359,315.59 dollars, or $1473.45 dollars per hospital encounter.

CONCLUSION:

These preliminary findings confirm data from other countries including England, that home/point of care testing for amniotic fluid leakage with a consumer-friendly diagnostic would be a cost-effective addition to healthcare. In addition to reducing costs by decreasing hospital encounters, this may alert women with ruptured membranes to appropriately visit the hospital for assessment and care and not assume urinary leakage as the cause.

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