Public or private? Cutting costs and improving the journey to motherhood
A James Cook University health economics researcher is leading a major new study on the type of maternity care that delivers the ‘best bang for the buck’.
Associate Professor Emily Callander, principal research fellow in health economics at the Australian Institute of Tropical Health and Medicine, recently found that expenses for obstetric services have soared by more than 1000 percent in Australia in just 25 years.
She’s now been granted a $437,000 National Health and Medical Research Council (NHMRC) fellowship to research the cost and outcomes of the pregnancy, obstetric and postnatal care of around 360,000 Queensland women who have given birth since 2012.
“For every woman having a baby we want to see which model of maternity care gives the best health outcomes and is also the most cost-effective,” she said.
The models being looked at are private obstetric-led care, private midwife-led care, and public hospital obstetric or midwifery care.
Dr Callander says her team want to find whether the higher cost models are worth it in terms of the best outcome.
“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,” said Dr Callander.
“The key part is that we actually are working directly with policy makers and health providers, so the research results can be used to change the way that maternity services are delivered”.
Dr Callander 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 over 25 years.
“It’s a double whammy,” says Dr Callander. “If you look overall at the different types of services covered by Medicare, obstetrics 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. It’s not surprising, I think that you're seeing a real decline in the number of women choosing to birth privately.”
Dr Callander said delivering maternity healthcare that produces the best value for money and the best clinical outcomes in the most efficient manner seems like a ‘no-brainer”.
The research will cover the costs and outcome of what she describes as “the whole care journey” of women from pregnancy through childbirth to two years afterwards.
Based on the results, Dr Callander intends developing an online data base that will allow women in Queensland to compare the costs and make informed decisions about the type of maternity care they want.
Dr Emily Callander
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