Using epidemiological and health economic measures to inform maternity staffing decisions: A guide.

Callander, E; Bull, C; Forster, D

Using epidemiological and health economic measures to inform maternity staffing decisions: A guide.

Callander, E

Bull, C Forster, D

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Women Birth, 2022, 35, (5), pp. e471-e476
Issue Date:: 2022-09

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Field	Value	Language
dc.contributor.author	Callander, E https://orcid.org/0000-0001-7233-6804
dc.contributor.author	Bull, C
dc.contributor.author	Forster, D
dc.date.accessioned	2023-02-13T04:12:11Z
dc.date.available	2021-12-07
dc.date.available	2023-02-13T04:12:11Z
dc.date.issued	2022-09
dc.identifier.citation	Women Birth, 2022, 35, (5), pp. e471-e476
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/166080
dc.description.abstract	BACKGROUND: There is growing concern around unnecessary intervention (particularly caesarean section) at birth in high-income countries. Caseload midwifery care aims to offset this, but is perceived to be costly to health services. AIM: To use epidemiological and health economic techniques to estimate health outcomes and cost-savings of different levels of equivalent full time (EFT) midwives working in caseload midwifery care. METHODS: Two simulations were conducted - one assuming 10 EFT midwives working in a caseload model, with 35 women per caseload, and one assuming 50 EFT midwives working in a caseload model, with 45 women per caseload. Both were based on a sample of 5000 women. The main model inputs included rates of health outcomes for women (caesarean section, epidural anaesthesia, and episiotomy) and infants (low birthweight and admissions to special care nursery (SCN) or neonatal intensive care unit (NICU)), and the cost savings associated with health outcome avoidance. FINDINGS: The first simulation estimated 27 fewer caesarean sections, 12 fewer epidurals, 12 fewer episiotomies, 10 fewer low birthweight births, and 23 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$1,874,715. The second simulation estimated 173 fewer caesarean sections, 76 fewer epidurals, 76 fewer episiotomies, 65 fewer low birthweight births, and 150 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$12,051,741. CONCLUSION: This study provides local-level decision-makers with a decision-tool to calculate the potentially avoidable health outcomes and cost savings associated with implementing caseload midwifery care in their own service.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Women Birth
dc.relation.isbasedon	10.1016/j.wombi.2021.12.001
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Birth Weight
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Midwifery
dc.subject.mesh	Parturition
dc.subject.mesh	Pregnancy
dc.subject.mesh	Workforce
dc.subject.mesh	Humans
dc.subject.mesh	Birth Weight
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Parturition
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Female
dc.subject.mesh	Workforce
dc.subject.mesh	Birth Weight
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Midwifery
dc.subject.mesh	Parturition
dc.subject.mesh	Pregnancy
dc.subject.mesh	Workforce
dc.title	Using epidemiological and health economic measures to inform maternity staffing decisions: A guide.
dc.type	Journal Article
utslib.citation.volume	35
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2023-02-13T04:12:09Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	35
utslib.citation.issue	5

Abstract:

BACKGROUND: There is growing concern around unnecessary intervention (particularly caesarean section) at birth in high-income countries. Caseload midwifery care aims to offset this, but is perceived to be costly to health services. AIM: To use epidemiological and health economic techniques to estimate health outcomes and cost-savings of different levels of equivalent full time (EFT) midwives working in caseload midwifery care. METHODS: Two simulations were conducted - one assuming 10 EFT midwives working in a caseload model, with 35 women per caseload, and one assuming 50 EFT midwives working in a caseload model, with 45 women per caseload. Both were based on a sample of 5000 women. The main model inputs included rates of health outcomes for women (caesarean section, epidural anaesthesia, and episiotomy) and infants (low birthweight and admissions to special care nursery (SCN) or neonatal intensive care unit (NICU)), and the cost savings associated with health outcome avoidance. FINDINGS: The first simulation estimated 27 fewer caesarean sections, 12 fewer epidurals, 12 fewer episiotomies, 10 fewer low birthweight births, and 23 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$1,874,715. The second simulation estimated 173 fewer caesarean sections, 76 fewer epidurals, 76 fewer episiotomies, 65 fewer low birthweight births, and 150 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$12,051,741. CONCLUSION: This study provides local-level decision-makers with a decision-tool to calculate the potentially avoidable health outcomes and cost savings associated with implementing caseload midwifery care in their own service.

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http://hdl.handle.net/10453/166080