Objective: To identify cost-opportunity that Hospital Nacional Cayetano Heredia (HNCH) presents for spontaneous normal vaginal deliveries. Design: Descriptive, transversal, observational study. Setting:Department of Gynecology and Obstetrics, Hospital Nacional Cayetano Heredia, Lima, Peru. Material: Clinical charts of patients attended for non complicated vaginal deliveries. Interventions: Clinical charts of 2 700 normal vaginal deliveries attended from January through December 2007 were reviewed and distributed according to mode of financing either by Sistema Integral de Salud (SIS) or by pocket payment; also SIS rejected cases were considered. Statistical analysis was done with commercial software. Main outcome measures: Shadow cost, costopportunity by SIS, pocket expense, cases rejected by SIS. Results: The total cost for spontaneous normal vaginal deliveries attended at HNCH was S/. ...

Objective: To identify cost-opportunity that Hospital Nacional Cayetano Heredia (HNCH) presents for spontaneous normal vaginal deliveries. Design: Descriptive, transversal, observational study. Setting:Department of Gynecology and Obstetrics, Hospital Nacional Cayetano Heredia, Lima, Peru. Material: Clinical charts of patients attended for non complicated vaginal deliveries. Interventions: Clinical charts of 2 700 normal vaginal deliveries attended from January through December 2007 were reviewed and distributed according to mode of financing either by Sistema Integral de Salud (SIS) or by pocket payment; also SIS rejected cases were considered. Statistical analysis was done with commercial software. Main outcome measures: Shadow cost, costopportunity by SIS, pocket expense, cases rejected by SIS. Results: The total cost for spontaneous normal vaginal deliveries attended at HNCH was S/. ...

Pneumonia due to Streptococcus pneumoniae (pneumococcus) is a major cause of mortality in infants (children under 1 year of age), and pneumococcal conjugate vaccines (PCVs), delivered during the first year of life, are available since the year 2000. Given those two premises, the conclusion follows logically that favourable impact reported for PCVs in preventing pneumococcal disease should be reflected in the infant mortality rates (IMRs) from all causes. Using publicly available datasets, country-level IMR estimates from UNICEF and PCV introduction status from WHO, country-specific time series analysed the temporal relationship between annual IMRs and the introduction of PCVs, providing a unique context into the long-term secular trends of IMRs in countries that included and countries that did not include PCVs in their national immunisation programmes. PCV status was available for 194 co...