A cost-benefit analysis of two alternative models of maternity care in Ireland
| 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.contributor.funder | University College Cork | en |
| dc.date.accessioned | 2017-09-12T15:54:30Z | |
| dc.date.available | 2017-09-12T15:54:30Z | |
| dc.date.issued | 2017-08-21 | |
| dc.date.updated | 2017-09-12T15:40:41Z | |
| 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.description.status | Peer reviewed | en |
| dc.description.version | Published Version | en |
| dc.format.mimetype | application/pdf | en |
| 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.doi | 10.1007/s40258-017-0344-8 | |
| dc.identifier.endpage | 10 | en |
| dc.identifier.issn | 1179-1896 | |
| dc.identifier.journaltitle | Applied Health Economics and Health Policy | en |
| dc.identifier.startpage | 1 | en |
| dc.identifier.uri | https://hdl.handle.net/10468/4693 | |
| 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 |
