Valuing maternity care: a comparison of stated preference methods with an application to cost-benefit analysis

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dc.check.embargoformatNot applicableen
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dc.contributor.advisorBourke, Janeen
dc.contributor.advisorMurphy, Aileenen
dc.contributor.advisorMurphy, Rosemaryen
dc.contributor.authorFawsitt, Christopher G.en
dc.contributor.funderNational Perinatal Epidemiology Centre, College of Medicine and Health, University College Corken
dc.date.accessioned2016-01-07T09:50:41Z
dc.date.available2016-01-07T09:50:41Z
dc.date.issued2015
dc.date.submitted2015
dc.description.abstractThis research investigates whether a reconfiguration of maternity services, which collocates consultant- and midwifery-led care, reflects demand and value for money in Ireland. Qualitative and quantitative research is undertaken to investigate demand and an economic evaluation is performed to evaluate the costs and benefits of the different models of care. Qualitative research is undertaken to identify women’s motivations when choosing place of delivery. These data are further used to inform two stated preference techniques: a discrete choice experiment (DCE) and contingent valuation method (CVM). These are employed to identify women’s strengths of preferences for different features of care (DCE) and estimate women’s willingness to pay for maternity care (CVM), which is used to inform a cost-benefit analysis (CBA) on consultant- and midwifery-led care. The qualitative research suggests women do not have a clear preference for consultant or midwifery-led care, but rather a hybrid model of care which closely resembles the Domiciliary Care In and Out of Hospital (DOMINO) scheme. Women’s primary concern during care is safety, meaning women would only utilise midwifery-led care when co-located with consultant-led care. The DCE also finds women’s preferred package of care closely mirrors the DOMINO scheme with 39% of women expected to utilise this service. Consultant- and midwifery-led care would then be utilised by 34% and 27% of women, respectively. The CVM supports this hierarchy of preferences where consultant-led care is consistently valued more than midwifery-led care – women are willing to pay €956.03 for consultant-led care and €808.33 for midwifery-led care. A package of care for a woman availing of consultant- and midwifery-led care is estimated to cost €1,102.72 and €682.49, respectively. The CBA suggests both models of care are cost-beneficial and should be pursued in Ireland. This reconfiguration of maternity services would maximise women’s utility, while fulfilling important objectives of key government policy.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Version
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFawsitt, C. 2015. Valuing maternity care: a comparison of stated preference methods with an application to cost-benefit analysis. PhD Thesis, University College Cork.en
dc.identifier.endpage506
dc.identifier.urihttps://hdl.handle.net/10468/2161
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2015, Christopher Fawsitt.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/en
dc.subjectDiscrete choice experimenten
dc.subjectContingent valuation methoden
dc.subjectCost-benefit analysisen
dc.subjectConsultant-led uniten
dc.subjectMidwifery-led uniten
dc.thesis.opt-outfalse
dc.titleValuing maternity care: a comparison of stated preference methods with an application to cost-benefit analysisen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhD (Commerce)en
ucc.workflow.supervisorjane.bourke@ucc.ie
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