Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study.
BMJ Open
; 7(9): e016960, 2017 Sep 11.
Article
en En
| MEDLINE
| ID: mdl-28893750
ABSTRACT
OBJECTIVES:
To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres.DESIGN:
Economic evaluation based on a prospective cohort study.SETTING:
21 Dutch birth centres, 46 hospital locations where midwife-led birth was possible and 110 midwifery practices where home birth was possible.PARTICIPANTS:
3455 low-risk women under the care of a community midwife at the start of labour in the Netherlands within the study period 1 July 2013 to 31 December 2013. MAIN OUTCOMEMEASURES:
Costs and health outcomes of birth for different planned places of birth. Healthcare costs were measured from start of labour until 7 days after birth. The health outcomes were assessed by the Optimality Index-NL2015 (OI) and a composite adverse outcomes score.RESULTS:
The total adjusted mean costs for births planned in a birth centre, in a hospital and at home under the care of a community midwife were 3327, 3330 and 2998, respectively. There was no difference between the score on the OI for women who planned to give birth in a birth centre and that of women who planned to give birth in a hospital. Women who planned to give birth at home had better outcomes on the OI (higher score on the OI).CONCLUSIONS:
We found no differences in costs and health outcomes for low-risk women under the care of a community midwife with a planned birth in a birth centre and in a hospital. For nulliparous and multiparous low-risk women, planned birth at home was the most cost-effective option compared with planned birth in a birth centre.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Centros de Asistencia al Embarazo y al Parto
/
Análisis Costo-Beneficio
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Parto Obstétrico
/
Parto Domiciliario
/
Hospitales
/
Partería
Tipo de estudio:
Etiology_studies
/
Health_economic_evaluation
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Observational_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Newborn
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
BMJ Open
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos