The Million Dollar Cesarean - ILPQC
Transcript of The Million Dollar Cesarean - ILPQC
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The Million Dollar Cesarean
Kristen Terlizzi
@kristenterlizzi
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• Patients are already familiar with the term and know
people who have had them
• A baby is involved, patients may not consider a
cesarean as they would any other major surgery
Cesareans are Common
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Maternal death may occur
despite optimal planning,
transfusion management,
and surgical care (ACOG)
Placenta Accreta Spectrum
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United States Cesarean Rates
6% of births
32% of births
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Data Source: SMFM & ACOG Obstetric Care Consenses #7 (2018) & SMFM Placenta Accreta Opinion in AJOG (2010)
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Placenta accreta now affects 1 in 272 pregnancies
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Complex Delivery Planning
• Gynecological Oncologists
• Interventional Radiologists
• Maternal-Fetal Medicine Specialists
• Neonatologists
• Obstetric Anesthesiologists
• Urologists
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Disseminated Intravascular Coagulation (DIC)
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What was the future cost of my primary cesarean?
• Accreta Diagnosis $8,101.00office visit, ultrasound, MRI – 6/26/14 – 6/30/14
• Mom’s Hospitalization #1 $805,372.30cesarean delivery, exploratory laparotomy, uterine artery embolization, 11 days antepartum, 3 days ICU, 34 days gynecological oncology - 7/5/14 – 8/20/14
• Infant Hospitalization $376,997.50born electively due to mother’s condition at 33w6d; 1 day NICU, 25 days Intermediate Care Nursery - 7/16/14 – 8/10/14
• Mom’s Hospitalization #2 $347,881.35emergent readmittance for DIC, hysterectomy with cervix, bladder resection, appendectomy, ureter re-implantation, 26 units of blood products, post op CT scan, 2 days ICU, 6 days gynecological oncology unit - 9/4/14 – 9/12/14
• 2014 Recovery $22,493.961 ER visit for post op bladder infection, 4 in home nursing visits, multiple urology and gynoncology follow up visits, stent removal, 14 pharmacy claims - 9/12/14 – 12/30/14
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The Future Cost of my Cesarean
In 2012, my cesarean was billed at $38,384.77
In 2014, my resulting placenta accreta delivery was
billed at
$1,560,846.11
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@kristenterlizzi www.preventaccreta.org/kristen