Improving quality and lowering costs in an integrated postabortion care model in Peru. Final report.

This paper presents the findings of an operations research project that assessed the effects of integration of treatment of abortion complications with postabortion family planning counseling and services in Lima Peru. The study focused on clinical treatment services postabortion family planning information provided to patients womens pain perceptions service delivery organization costs to both the hospital and patient and potential for long-term sustainability of the integrated model. It used a quasi-experimental pre-post intervention design and was conducted at National Hospital "Daniel Alcides Carrion. The information sources for the study include the following: patient exit interview; clinical history form; cost and resource use component; logbook review; and in-depth interviews with patients providers and policy-makers. Findings showed that in most hospitals in the region family planning offered to postabortion patients was virtually nonexistent prior to the implementation of the integrated model. Improvements in postabortion family planning were facilitated by the presence of a strong family planning clinic in the hospital. Sustainability should be a major goal of any postabortion care (PAC) model. Incorporation of manual vacuum aspiration and other PAC content into routine obstetrics-gynecology training for residents and other staff was a landmark for sustainability. Hospital officials rated the prospects for sustainability of the integrated PAC services as high.