Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland

Abstract

Objective. This study sought to compare costs for women giving birth in different public hospital services across Queensland and their babies.Methods. A whole-of-population linked administrative dataset was used containing all health service use in a public hospital in Queensland for women who gave birth between 1 July 2012 and 30 June 2015 and their babies. Generalised linear models were used to compare costs over the first 1000 days between hospital and health services.Results. The mean unadjusted cost for each woman and her baby (n = 134 910) was A$17406 in the first 1000 days. After adjusting for clinical and demographic factors and birth type, women and their babies who birthed in the Cairns Hospital and Health Service (HHS) had costs 19% lower than those who birthed in Gold Coast HHS (95% confidence interval (CI) -32%, -4%); women and their babies who birthed at the Mater public hospitals had costs 28% higher than those who birthed at Gold Coast HHS (95% CI 8, 51).Conclusions. There was considerable variation in costs between hospital and health services in Queensland for the costs of delivering maternity care. Cost needs to be considered as an important additional element of monitoring programs.What is known about the topic? The Australian maternal care system delivers high-quality, safe care to Australian mothers. However, this comes at a considerable financial cost to the Australian public health system. It is known that there are variations in the cost of care depending upon the model of care a woman receives, and the type of delivery she has, with higher-cost treatment not necessarily being safer or producing better outcomes. What does this paper add? This paper compares the cost of delivering a full cycle of maternity care to a woman at different HHSs across Queensland. It demonstrates that there is considerable variation in cost across HHSs, even after adjusting for clinical and demographic factors. What are the implications for practitioners? Reporting of cost should be an ongoing part of performance monitoring in public hospital maternity care alongside clinical outcomes to ensure the sustainability of the high-quality maternal health care Australian public hospitals deliver.

The opportunity costs of birth in Australia: Hospital resource savings for a post–COVID‐19 era

“…Matching scores were based on a woman's age, BMI score, if it was the woman's first pregnancy, smoking status before 20 weeks’ gestation, Indigenous identification, socioeconomic status, and rurality of residence. These variables were chosen as they have previously been shown to be associated with total health care costs 28 —an outcome of primary importance 29 —but not influenced by mode of birth. Recipient and donor records were matched if their score fell within 0.02 standard deviations of the logit of the matching score, using the greedy matching technique.…”

An exploration of potential output measures to assess efficiency and productivity for labour and birth in Australia

“…Using an existing whole-of-population linked administrative dataset [13] we applied our composite outcome measure to demonstrate the change in the Production Function if all births (quantity) were used as the output or only births that met the criteria of the composite outcome measure (quantity and quality). The linked administrative dataset covers all births in the Australian state Queensland, between 1st July 2012 and 30th June 2015.…”

“…It utilizes the Queensland Perinatal Data Collection to identify births, and was then linked to the Queensland Hospital Admitted Patient Data Collection, Queensland Emergency Department Collection, and Medical Benefits Schedule and Pharmaceutical benefits Scheme (PBS) claims records. Together this data set records the cost to governments (public hospital funders, Medicare, the PBS), private health insurers and individuals through out of pocket costs [13].…”

Cohort profile: the eLIXIR Partnership—a maternity–child data linkage for life course research in South London, UK

“…14 Several linkages of clinical maternity and infant data have nonetheless shown the feasibility of the approach and usefulness, for example, in aligning hospital maternity data with national birth registration datasets, or birth registration datasets with Hospital Episode Statistics (HES), or using UK primary care pregnancy data to create a pregnancy register. [15][16][17][18][19][20][21][22][23][24][25] It is well established that maternal physical and mental well-being in pregnancy and the postpartum period can strongly influence the neonatal outcome and the physical and mental health of the child. [26][27][28][29] To our knowledge, no clinical data linkages in maternity or neonatal services have to date incorporated clinical information from maternity, neonatal and mental health services into a single continuum to interrogate these associations at a population level.…”