A cost-consequences analysis of a Midwifery Group Practice for Aboriginal mothers and infants in the Top End of the Northern Territory, Australia

被引：48

作者：

Gao, Yu ^{[1
,2
]}

Gold, Lisa ^{[1
]}

Josif, Cath ^{[1
]}

Bar-Zeev, Sarah

Steenkamp, Malinda ^{[7
]}

Barclay, Lesley ^{[1
]}

Zhao, Yuejen ^{[3
]}

Tracy, Sally ^{[4
]}

Kildea, Sue ^{[5
,6
]}

机构：

[1] Univ Sydney, Sydney Med Sch, Sch Publ Hlth, Univ Ctr Rural Hlth North Coast, Lismore, NSW 2480, Australia

[2] Deakin Univ, Deakin Populat Hlth SRC, Burwood, Vic 3125, Australia

[3] Northern Terr Dept Hlth, Darwin, NT 0811, Australia

[4] Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia

[5] Australian Catholic Univ, Womens Hlth & Newborn Serv, Brisbane, Qld 4101, Australia

[6] Mater Mothers Hosp, Brisbane, Qld 4101, Australia

[7] Univ Adelaide, Life Course & Intergenerat Hlth Res Grp LIGHt, Discipline Obstet & Gynaecol, Fac Hlth Sci, Adelaide, SA 5005, Australia

来源：

MIDWIFERY | 2014年 / 30卷 / 04期

基金：

英国医学研究理事会;

关键词：

Midwifery Group Practice; Cost-consequences analysis; Indigenous; Australia; CASELOAD MIDWIFERY; CARE; CONTINUITY; BIRTH; RISK;

D O I：

10.1016/j.midw.2013.04.004

中图分类号：

R47 [护理学];

学科分类号：

1011 ;

摘要：

Objective: to compare the cost-effectiveness of two models of service delivery : Midwifery Group Practice (MGP) and baseline cohort. Design: a retrospective and prospective cohort study. Setting: a regional hospital in Northern Territory (NT), Australia. Methods: baseline cohort included all Aboriginal mothers (n=412), and their infants (n=416), from two remote communities who gave birth between 2004 and 2006. The MGP cohort included all Aboriginal mothers (n=310), and their infants (n=315), from seven communities who gave birth between 2009 and 2011. The baseline cohort mothers and infant's medical records were retrospectively audited and the MGP cohort data were prospectively collected. All the direct costs, from the Department of Health (DH) perspective, occurred from the first antenatal presentation to six weeks post partum for mothers and up to 28 days post births for infants were included for analysis. Analysis: analysis was performed with SPSS 19.0 and Stata 12.1. Independent sample of t-tests and chi 2 were conducted. Findings: women receiving MGP care had significantly more antenatal care, more ultrasounds, were more likely to be admitted to hospital antenatally, and had more postnatal care in town. The MGP cohort had significantly reduced average length of stay for infants admitted to Special Care Nursery (SCN). There was no significant difference between the two cohorts for major birth outcomes such as mode of birth, preterm birth rate and low birth weight. Costs savings (mean A$703) were found, although these were not statistically significant, for women and their infants receiving MGP care compared to the baseline cohort. Conclusions: for remote dwelling Aboriginal women of all risk who travelled to town for birth, MGP was likely to be cost effective, and women received better care and resulting in equivalent birth outcomes compared with the baseline maternity care. (C) 2013 Elsevier Ltd. All rights reserved.

引用

页码：447 / 455

页数：9

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