Evidence map›Paper›PMID 34391422›Full record

ArticleBMC health services research2021

Modelling the cost of place of birth: a pathway analysis.

Vanessa L Scarf, Serena Yu, Rosalie Viney, Seong Leang Cheah, Hannah Dahlen, David Sibbritt, Charlene Thornton, Sally Tracy, Caroline Homer

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Vanessa L ScarfCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, 2007, Australia. vanessa.scarf@uts.edu.au.ORCID http://orcid.org/0000-0003-3503-9610
Serena YuCentre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia.
Rosalie VineyCentre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia.
Seong Leang CheahCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, 2007, Australia.
Hannah DahlenSchool of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
David SibbrittCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, 2007, Australia.
Charlene ThorntonUniversity of Sydney, Sydney, Australia.
Sally TracyCollege of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Caroline HomerCentre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, 2007, Australia.
University of Technology Sydney · AUFlinders University · AUThe University of Sydney · AUWestern Sydney University · AU

Funding

Australian National Health and Medical Research Council APP: 1103015
6 · The paper itself

Abstract

backgroundIn New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Availability of alternative birth settings is limited and the cost of providing birth at home or in a birth centre from the perspective of the health system is unknown.

objectivesThe objective of this study was to model the cost of the trajectories of women who planned to give birth at home, in a birth centre or in a hospital from the public sector perspective.

methodsThis was a population-based study using linked datasets from NSW, Australia. Women included met the following selection criteria: 37-41 completed weeks of pregnancy, spontaneous onset of labour, and singleton pregnancy at low risk of complications. We used a decision tree framework to depict the trajectories of these women and Australian Refined-Diagnosis Related Groups (AR-DRGs) were applied to each trajectory to estimate the cost of birth. A scenario analysis was undertaken to model the cost for 30 000 women in one year.

findings496 387 women were included in the dataset. Twelve potential outcome pathways were identified and each pathway was costed using AR-DRGs. An overall cost was also calculated by place of birth: $AUD4802 for homebirth, $AUD4979 for a birth centre birth and $AUD5463 for a hospital birth.

conclusionThe findings from this study provides some clarity into the financial saving of offering more options to women seeking an alternative to giving birth in hospital. Given the relatively lower rates of complex intervention and neonatal outcomes associated with women at low risk of complications, we can assume the cost of providing them with homebirth and birth centre options could be cost-effective.

Indexed as

Birthing CentersHome ChildbirthAustraliaBirth SettingFemaleHumansInfant, NewbornParturitionPregnancyBirth centreChildbirthCostDecision treeEconomic analysisHomebirth

Identifiers

PMID34391422
PMCPMC8364024
OpenAlexW3193528186

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.