# How much can we reduce delivery-related medical costs associated with maternal mortality? A nationwide cohort study from 2003 to 2021

## TL;DR

This study shows that maternal mortality in South Korea is linked to significantly higher delivery-related medical costs, suggesting that improving maternal health could reduce these expenses.

## Contribution

The study quantifies the potential reduction in delivery-related medical costs if maternal mortality is addressed in South Korea.

## Key findings

- Maternal mortality cases had delivery-related medical costs about six times higher than non-maternal mortality cases.
- Approximately 83% of direct medical costs from maternal mortality could be reduced with better maternal health interventions.
- Maternal mortality accounted for 0.06% of total delivery-related medical costs in South Korea.

## Abstract

This study aims to examine the association between maternal mortality and childbirth-related medical costs using both unadjusted and adjusted models and to assess the potential reduction in delivery-related medical costs associated with maternal mortality in South Korea.

This retrospective cohort study used data from the National Health Insurance Service Delivery Cohort Database of South Korea. A total of 7,171,578 participants were included. The outcome measured was delivery-related medical costs associated with maternal mortality. A Generalized Estimating Equation model with a log link and gamma distribution was used to estimate delivery-related medical costs.

The maternal death rates were 9.7 per 100,000 births. The adjusted mean delivery-related medical costs were approximately six times higher in cases with maternal death than in those without ($2,802 vs. $480, p < 0.0001). The total delivery-related medical costs for all women with maternal mortality were approximately $2 million, accounting for 0.06% of total delivery-related medical costs. Although this proportion is relatively small, 83% of the direct medical costs associated with maternal mortality among South Korean women were potentially reducible.

This study found that maternal mortality is associated with significantly higher delivery-related medical costs, nearly six times those of non-maternal mortality cases. Therefore, policymakers should consider reducing costs and improving maternal health outcomes, expanding access to prenatal care for early risk detection and strengthen nationwide maternal health monitoring systems.