A cost-benefit analysis of two alternative models of maternity care in Ireland

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dc.contributor.author Fawsitt, Christopher G.
dc.contributor.author Bourke, Jane
dc.contributor.author Murphy, Aileen
dc.contributor.author McElroy, Brendan
dc.contributor.author Lutomski, Jennifer E.
dc.contributor.author Murphy, Rosemary
dc.contributor.author Greene, Richard A.
dc.date.accessioned 2017-09-12T15:54:30Z
dc.date.available 2017-09-12T15:54:30Z
dc.date.issued 2017-08-21
dc.identifier.citation Fawsitt, C. G., Bourke, J., Murphy, A., McElroy, B., Lutomski, J. E., Murphy, R. and Greene, R. A. (2017) 'A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland', Applied Health Economics and Health Policy. In Press. doi: 10.1007/s40258-017-0344-8 en
dc.identifier.startpage 1 en
dc.identifier.endpage 10 en
dc.identifier.issn 1179-1896
dc.identifier.uri http://hdl.handle.net/10468/4693
dc.identifier.doi 10.1007/s40258-017-0344-8
dc.description.abstract Background: The Irish government has committed to expand midwifery-led care alongside consultant-led care nationally, although very little is known about the potential net benefits of this reconfiguration. Objectives: To formally compare the costs and benefits of the major models of care in Ireland, with a view to informing priority setting using the contingent valuation technique and cost-benefit analysis. Methods: A marginal payment scale willingness-to-pay question was adopted from an ex ante perspective. 450 pregnant women were invited to participate in the study. Cost estimates were collected primarily, describing the average cost of a package of care. Net benefit estimates were calculated over a 1-year cycle using a third-party payer perspective. Results: To avoid midwifery-led care, women were willing to pay €821.13 (95% CI 761.66–1150.41); to avoid consultant-led care, women were willing to pay €795.06 (95% CI 695.51–921.15). The average cost of a package of consultant- and midwifery-led care was €1,762.12 (95% CI 1496.73–2027.51) and €1018.47 (95% CI 916.61–1120.33), respectively. Midwifery-led care ranked as the best use of resources, generating a net benefit of €1491.22 (95% CI 989.35–1991.93), compared with €123.23 (95% CI −376.58 to 621.42) for consultant-led care. Conclusions: While both models of care are cost-beneficial, the decision to provide both alternatives may be constrained by resource issues. If only one alternative can be implemented then midwifery-led care should be undertaken for low-risk women, leaving consultant-led care for high-risk women. However, pursuing one alternative contradicts a key objective of government policy, which seeks to improve maternal choice. Ideally, multiple alternatives should be pursued. en
dc.description.sponsorship University College Cork (National Perinatal Epidemiology Centre) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Springer International Publishing; Adis en
dc.rights © The Authors 2017. Open Access: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/ en
dc.subject Midwifery en
dc.subject Midwifery-led care en
dc.subject Cost-benefit analysis en
dc.subject Cost-beneficial en
dc.subject Consultant-led care en
dc.subject Naternal choice en
dc.subject Risk en
dc.title A cost-benefit analysis of two alternative models of maternity care in Ireland en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Jane Bourke, Economics, University College Cork, Cork, Ireland. +353-21-490-3000 Email: jane.bourke@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2017-09-12T15:40:41Z
dc.description.version Published Version en
dc.internal.rssid 407848179
dc.contributor.funder University College Cork en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Applied Health Economics and Health Policy en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress Jane.Bourke@ucc.ie en


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© The Authors 2017. Open Access: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Except where otherwise noted, this item's license is described as © The Authors 2017. Open Access: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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