Modelling the cost of place of birth: a pathway analysis
Abstract Background In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Avail...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-021-06810-9 |
| _version_ | 1819094711215849472 |
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| author | Vanessa L. Scarf Serena Yu Rosalie Viney Seong Leang Cheah Hannah Dahlen David Sibbritt Charlene Thornton Sally Tracy Caroline Homer |
| author_facet | Vanessa L. Scarf Serena Yu Rosalie Viney Seong Leang Cheah Hannah Dahlen David Sibbritt Charlene Thornton Sally Tracy Caroline Homer |
| author_sort | Vanessa L. Scarf |
| collection | DOAJ |
| description | Abstract Background In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Availability of alternative birth settings is limited and the cost of providing birth at home or in a birth centre from the perspective of the health system is unknown. Objectives The objective of this study was to model the cost of the trajectories of women who planned to give birth at home, in a birth centre or in a hospital from the public sector perspective. Methods This was a population-based study using linked datasets from NSW, Australia. Women included met the following selection criteria: 37-41 completed weeks of pregnancy, spontaneous onset of labour, and singleton pregnancy at low risk of complications. We used a decision tree framework to depict the trajectories of these women and Australian Refined-Diagnosis Related Groups (AR-DRGs) were applied to each trajectory to estimate the cost of birth. A scenario analysis was undertaken to model the cost for 30 000 women in one year. Findings 496 387 women were included in the dataset. Twelve potential outcome pathways were identified and each pathway was costed using AR-DRGs. An overall cost was also calculated by place of birth: $AUD4802 for homebirth, $AUD4979 for a birth centre birth and $AUD5463 for a hospital birth. Conclusion The findings from this study provides some clarity into the financial saving of offering more options to women seeking an alternative to giving birth in hospital. Given the relatively lower rates of complex intervention and neonatal outcomes associated with women at low risk of complications, we can assume the cost of providing them with homebirth and birth centre options could be cost-effective. |
| first_indexed | 2024-12-21T23:31:45Z |
| format | Article |
| id | doaj.art-37bc80f68360460fbf58784a73de5c73 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-21T23:31:45Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-37bc80f68360460fbf58784a73de5c732022-12-21T18:46:28ZengBMCBMC Health Services Research1472-69632021-08-0121111110.1186/s12913-021-06810-9Modelling the cost of place of birth: a pathway analysisVanessa L. Scarf0Serena Yu1Rosalie Viney2Seong Leang Cheah3Hannah Dahlen4David Sibbritt5Charlene Thornton6Sally Tracy7Caroline Homer8Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology SydneyCentre for Health Economics Research and Evaluation, University of Technology SydneyCentre for Health Economics Research and Evaluation, University of Technology SydneyCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology SydneySchool of Nursing and Midwifery, Western Sydney UniversityCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology SydneyUniversity of SydneyCollege of Nursing and Health Sciences, Flinders UniversityCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology SydneyAbstract Background In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Availability of alternative birth settings is limited and the cost of providing birth at home or in a birth centre from the perspective of the health system is unknown. Objectives The objective of this study was to model the cost of the trajectories of women who planned to give birth at home, in a birth centre or in a hospital from the public sector perspective. Methods This was a population-based study using linked datasets from NSW, Australia. Women included met the following selection criteria: 37-41 completed weeks of pregnancy, spontaneous onset of labour, and singleton pregnancy at low risk of complications. We used a decision tree framework to depict the trajectories of these women and Australian Refined-Diagnosis Related Groups (AR-DRGs) were applied to each trajectory to estimate the cost of birth. A scenario analysis was undertaken to model the cost for 30 000 women in one year. Findings 496 387 women were included in the dataset. Twelve potential outcome pathways were identified and each pathway was costed using AR-DRGs. An overall cost was also calculated by place of birth: $AUD4802 for homebirth, $AUD4979 for a birth centre birth and $AUD5463 for a hospital birth. Conclusion The findings from this study provides some clarity into the financial saving of offering more options to women seeking an alternative to giving birth in hospital. Given the relatively lower rates of complex intervention and neonatal outcomes associated with women at low risk of complications, we can assume the cost of providing them with homebirth and birth centre options could be cost-effective.https://doi.org/10.1186/s12913-021-06810-9Economic analysisChildbirthCostHomebirthBirth centreDecision tree |
| spellingShingle | Vanessa L. Scarf Serena Yu Rosalie Viney Seong Leang Cheah Hannah Dahlen David Sibbritt Charlene Thornton Sally Tracy Caroline Homer Modelling the cost of place of birth: a pathway analysis BMC Health Services Research Economic analysis Childbirth Cost Homebirth Birth centre Decision tree |
| title | Modelling the cost of place of birth: a pathway analysis |
| title_full | Modelling the cost of place of birth: a pathway analysis |
| title_fullStr | Modelling the cost of place of birth: a pathway analysis |
| title_full_unstemmed | Modelling the cost of place of birth: a pathway analysis |
| title_short | Modelling the cost of place of birth: a pathway analysis |
| title_sort | modelling the cost of place of birth a pathway analysis |
| topic | Economic analysis Childbirth Cost Homebirth Birth centre Decision tree |
| url | https://doi.org/10.1186/s12913-021-06810-9 |
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