Annals of global health
Cost-Utility and Clinical Impact of a Multicomponent Maternal Safety and High-Dependency Care Model in Three Colombian Caribbean Hospitals: A Before-and-After Study
By Rojas-Suárez J, Durán C, Lora N and 14 others.
Abstract
Background
Obstetric high-dependency units may improve rescue care when embedded within broader maternal safety strategies.
Objective
To evaluate a multi-component maternal safety and technological strengthening model, including obstetric high-dependency capacity, across three Colombian Caribbean institutions with different governance models.
Methods
We conducted a multisite before-and-after implementation evaluation within a Ministry-funded maternal safety project. The model was implemented in one private clinic and two public hospitals in La Guajira and Bolívar, Colombia, with staggered implementation and varying data maturity. Data sources included billing records, administrative databases, and monthly quality indicators. Costs, severe maternal morbidity indicators, and longitudinal quality metrics were analysed by institutional implementation window. Pandemic-period variation from 2018 to 2023 was treated descriptively. Interrupted time series analyses were performed where post-implementation data allowed.