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A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland

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A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland. / Fawsitt, Christopher G; Bourke, Jane; Murphy, Aileen; McElroy, Brendan; Lutomski, Jennifer E; Murphy, Rosemary; Greene, Richard A.

In: Applied Health Economics and Health Policy, 21.08.2017.

Research output: Contribution to journalArticle

Harvard

Fawsitt, CG, Bourke, J, Murphy, A, McElroy, B, Lutomski, JE, Murphy, R & Greene, RA 2017, 'A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland', Applied Health Economics and Health Policy. https://doi.org/10.1007/s40258-017-0344-8

APA

Fawsitt, C. G., Bourke, J., Murphy, A., McElroy, B., Lutomski, J. E., Murphy, R., & Greene, R. A. (2017). A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland. Applied Health Economics and Health Policy. https://doi.org/10.1007/s40258-017-0344-8

Vancouver

Fawsitt CG, Bourke J, Murphy A, McElroy B, Lutomski JE, Murphy R et al. A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland. Applied Health Economics and Health Policy. 2017 Aug 21. https://doi.org/10.1007/s40258-017-0344-8

Author

Fawsitt, Christopher G ; Bourke, Jane ; Murphy, Aileen ; McElroy, Brendan ; Lutomski, Jennifer E ; Murphy, Rosemary ; Greene, Richard A. / A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland. In: Applied Health Economics and Health Policy. 2017.

Bibtex

@article{073947d7bc9f4ee5afeaaed8f382941a,
title = "A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland",
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.",
keywords = "Journal Article",
author = "Fawsitt, {Christopher G} and Jane Bourke and Aileen Murphy and Brendan McElroy and Lutomski, {Jennifer E} and Rosemary Murphy and Greene, {Richard A}",
year = "2017",
month = "8",
day = "21",
doi = "10.1007/s40258-017-0344-8",
language = "English",
journal = "Applied Health Economics and Health Policy",
issn = "1175-5652",
publisher = "Springer Verlag",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland

AU - Fawsitt, Christopher G

AU - Bourke, Jane

AU - Murphy, Aileen

AU - McElroy, Brendan

AU - Lutomski, Jennifer E

AU - Murphy, Rosemary

AU - Greene, Richard A

PY - 2017/8/21

Y1 - 2017/8/21

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1007/s40258-017-0344-8

DO - 10.1007/s40258-017-0344-8

M3 - Article

JO - Applied Health Economics and Health Policy

JF - Applied Health Economics and Health Policy

SN - 1175-5652

ER -