Community-based continuity of midwifery care versus standard hospital care: a cost analysis

Abstract

Abstract

Women's experiences of continuity of midwifery care in a randomised controlled trial in Australia

“…The STOMP model was established within the existing budget of a metropolitan teaching hospital and evaluated in a randomised controlled trial. The clinical outcomes, antenatal experiences of women and costs are reported elsewhere (Homer et al 2000;Homer et al 2001b;Homer et al 2001a). An important outcome measure in the trial was the experience of women as measured in the postnatal period.…”

A non-randomised trial investigating the cost-effectiveness of Midwifery Group Practice compared with standard maternity care arrangements in one Australian hospital

“…This study endeavours to provide an economic evaluation at a local level and is consistent with previous Australian (Byrne et al, 2000;Homer et al, 2001;Tracy and Hartz, 2006), UK (Young et al, 1997) and USA (Stone and Walker, 1995) continuity of midwifery cost analyses. …”

“…In Australia, team midwifery incorporating antenatal care in a community setting (Homer et al, 2001) and Midwifery Group Practice in a stand-alone unit have been found to be cost effective (Tracy and Hartz, 2006). A comparison of birth centre care alongside a tertiary level conventional delivery suite found no difference in costs (Byrne et al, 2000).…”

Economic evaluation of birth care in low-risk women. A comparison between a midwife-led birth unit and a standard obstetric unit within the same hospital in Norway. A randomised controlled trial

“…Another Australian study comparing care by a midwife team versus routine care for both low-and high-risk women revealed that team care resulted in a cost reduction of 4.5% (Rowley et al, 1995). A third article from Australia presenting a cost analysis comparing community-based continuity of midwifery care versus standard hospital care, found that the mean costs were lower for the community-based continuity of midwifery care even after adjusting for caesarean sections (Homer et al, 2001). Even though these trials are conducted in the same country a comparison is difficult due to varied organisation of birth care and different structure of the trials (Rowley et al, 1995;Byrne et al, 2000;Homer et al, 2001).…”

“…A third article from Australia presenting a cost analysis comparing community-based continuity of midwifery care versus standard hospital care, found that the mean costs were lower for the community-based continuity of midwifery care even after adjusting for caesarean sections (Homer et al, 2001). Even though these trials are conducted in the same country a comparison is difficult due to varied organisation of birth care and different structure of the trials (Rowley et al, 1995;Byrne et al, 2000;Homer et al, 2001). A study from the USA showed that there were no differences in costs when comparing a freestanding birth centre to "traditional care" in a central New York community, but a sensitivity analysis demonstrated that freestanding birth centres could be cost effective if they increased their volume (Stone et al, 2000).…”