Cutting costs and improving the journey to motherhood
After finding that expenses for obstetric services had soared by more than 1000 percent in Australia in just 25 years, a James Cook University health economics researcher is leading a major new study on the model of maternity care that delivers the “best bang for the buck” and gives women the best health outcomes.
Associate Professor Emily Callander,
Callander says: “I think within Australia, there is a notable absence of economic-informed decision making around maternity care. It’s an area that has escaped a lot of research attention in terms of looking at the value of different models of care and that’s really what my fellowship aims to address.”
“The key part is that we actually are working directly with
As a health economist, Callander says she chose this field of research because she is a big believer in equity
Callander is particularly concerned about ensuring equal access to good quality maternity care for people living in remote areas as well as Aboriginal and Torres
She and her colleague Haylee Fox recently published the results of a study showing that out of pocket fees for obstetric services had increased by more than 1000 percent while the cost of in-hospital obstetric services had increased by 77 percent increase over 25 years.
“It’s a double whammy,” says Callander. “If you look overall at the different types of services covered by Medicare, obstetrics literally stand out as being some of the most expensive, but also the ones that have increased astronomically in that time period as well. So, there really is that anomaly. So, it’s not surprising, I think, that you're seeing a real decline in the number of women choosing to birth privately.”
In the new study, Callander and her team are looking at data for 186,000 Queensland women who gave birth between 2012 and 2015 and their 189,000 babies. They intend extending the research to another 186,000 odd women who delivered between 2015 and 2018.
“So for every woman having a baby in we want to see which model of maternity care gives the best health outcomes and is also the most
The public data the researchers are using covers the types of maternity services accessed by individual women. Callander says no identifying information is released and absolutely no personal details. The data includes details such as whether someone was triaged in
Callander says delivering maternity healthcare that produces the best value for money and the best clinical outcomes in the most efficient manner
The reason they are looking at such a long period is that the 1000 days after birth are vital for the baby and mother. “So, there is this whole postnatal journey that each woman has to go through. And particularly when you look at postnatal depression and follow-on mental health issues that have a longer time horizon, I think it’s quite important to go out that extra period of time, but also potentially for repeat pregnancies as well.”
For example, women who have had an initial
Callander said they had found that in private Queensland facilities only 22
Based on the results, Callander intends developing an online
Callander adds: “I think this is exactly the sorts of things that patients need not just within maternity care even, but just across Australia, we really need with the public and private healthcare models that we have access to this type of transparent information.”
Associate Professor Emilly Callander
The National Women's Health Strategy 2020-2030
National Health and Medical Research Council