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

Bernitz, Stine; Aas, Eline; Øian, Pål

doi:10.1016/j.midw.2012.06.001

Cited by 35 publications

(30 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The perspectives of the studies included societal [ 14 , 28 ], Medicaid or the Government [ 19 , 21 , 23 , 29 , 30 ], the individual health service [ 31 , 32 ] and the insurer [ 33 ]. The variation in the perspective was reflected in the identification and collection of the resource use data to measure the costs of the alternative birth settings.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Costing Alternative Birth Settings for Women at Low Risk of Complications: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

BackgroundThere is demand from women for alternatives to giving birth in a standard hospital setting however access to these services is limited. This systematic review examines the literature relating to the economic evaluations of birth setting for women at low risk of complications.MethodsSearches of the literature to identify economic evaluations of different birth settings of the following electronic databases: MEDLINE, CINAHL, EconLit, Business Source Complete and Maternity and Infant care. Relevant English language publications were chosen using keywords and MeSH terms between 1995 and 2015. Inclusion criteria included studies focussing on the comparison of birth setting. Data were extracted with respect to study design, perspective, PICO principles, and resource use and cost data.ResultsEleven studies were included from Australia, Canada, the Netherlands, Norway, the USA, and the UK. Four studies compared costs between homebirth and the hospital setting and the remaining seven focussed on the cost of birth centre care and the hospital setting. Six studies used a cost-effectiveness analysis and the remaining five studies used cost analysis and cost comparison methods. Eight of the 11 studies found a cost saving in the alternative settings. Two found no difference in the cost of the alternative settings and one found an increase in birth centre care.ConclusionsThere are few studies that compare the cost of birth setting. The variation in the results may be attributable to the cost data collection processes, difference in health systems and differences in which costs were included. A better understanding of the cost of birth setting is needed to inform policy makers and service providers.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Six of the eleven appraised studies performed a cost-effectiveness analysis. [ 21 , 23 , 29 , 31 , 33 ] This was the most common methodology reported with the other method being cost analysis. [ 14 , 19 , 30 , 32 , 34 ]…”

Section: Resultsmentioning

confidence: 99%

Costing Alternative Birth Settings for Women at Low Risk of Complications: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Midwife-led models of care include continuous support, continuity of care provider and a home-like environment for women with low risk during pregnancy and childbirth [3, 4], and there is good scientific evidence that continuous support during labour and birth offers several advantages and no adverse effects [5–7]. A framework mixed-methods analysis identified reasons as to why midwifery care during pregnancy and childbirth is beneficial, including; midwifery care supports normality in pregnancy and childbirth, focuses on prevention and support, stresses respectful relationships, and is cost-effective [8–10]. In addition, midwife-led models include continuity of childbirth care, which is also important for women [11].…”

Section: Introductionmentioning

confidence: 99%

Midwife-led maternity care in Ireland – a retrospective cohort study

Dencker

Smith

McCann

et al. 2017

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background: Midwife-led maternity care is shown to be safe for women with low-risk during pregnancy. In Ireland, two midwife-led units (MLUs) were introduced in 2004 when a randomised controlled trial (the MidU study) was performed to compare MLU care with consultant-led care (CLU). Following study completion the two MLUs have remained as a maternity care option in Ireland. The aim of this study was to evaluate maternal and neonatal outcomes and transfer rates during six years in the larger of the MLU sites. Methods: MLU data for the six years 2008-2013 were retrospectively analysed, following ethical approval. Rates of transfer, reasons for transfer, mode of birth, and maternal and fetal outcomes were assessed. Linear-by-Linear Association trend analysis was used for categorical data to evaluate trends over the years and one-way ANOVA was used when comparing continuous variables. Results: During the study period, 3,884 women were registered at the MLU. The antenatal transfer rate was 37.4% and 2,410 women came to labour in the MLU. Throughout labour and birth, 567 women (14.6%) transferred to the CLU, of which 23 were transferred after birth due to need for suturing or postpartum hemorrhage. The most common reasons for intrapartum transfer were meconium stained liquor/abnormal fetal heart rate (30.3%), delayed labour progress in first or second stage (24.9%) and woman's wish for epidural analgesia (15.1%). Of the 1,903 babies born in the MLU, 1,878 (98.7%) were spontaneous vaginal births and 25 (1.3%) were instrumental (ventouse/ forceps). Only 25 babies (1.3%) were admitted to neonatal intensive care unit. All spontaneous vaginal births from the MLU registered population, occurring in the study period in both the MLU and CLU settings (n = 2,785), were compared. In the MLU more often 1-2 midwives (90.9% vs 69.7%) cared for the women during birth, more women had three vaginal examinations or fewer (93.6% vs 79.9%) and gave birth in an upright position (standing, squatting or kneeling) (52.0% vs 9.4%), fewer women had an amniotomy (5.9% vs 25.9%) or episiotomy (3.4% vs 9.7%) and more women had a physiological management of third stage of labour (50.9% vs 4.6%). Conclusions: Midwife-led care is a safe option that could be offered to a large proportion of healthy pregnant women. With strict transfer criteria there are very few complications during labour and birth. Maternity units without the option of MLU care should consider its introduction.

show abstract

“…The result has been an increase in births on the hospital premises, but fewer in the secondary level service, with overall improvement in cost-effectiveness and outcomes. Similar models have been found to be cost-effective in a well-resourced setting, [ 29 ] to be safe in a Japanese setting, [ 30 ] and in China to be associated with improved satisfaction and labour outcomes. Treatment decisions are also complicated by the fact that the cause of the PPH may not be apparent, and there may be more than one cause.…”

Section: Place Of Birthmentioning

confidence: 66%