Dear
The Centre for Midwifery Practice at Thames Valley University, London,
undertook a detailed economic evaluation of caseload midwifery
practices compared with conventional maternity care and found them no
more expensive. The analysis was udertaken by York Health Economics
Consortium. The results have not yet been published in a journal but
you can obtain copies of our overall evaluation report, which includes
economics and YHEC's detailed economic evaluation report by sending
request with £8 (to cover costs) to:
Merle Mullings, Administrator
Centre for Midwifery Practice
Queen Charlotte's Hospital
London W6 0XG.
0181-383-3599
The study was very detailed and looked at all costs we could count,
including staff. We made careful checks on data quality and also
undertook a modelling exercise to look at the implications of having
caseload midwives at different levels in the service. The scheme was
set up without any additional funding, mainly by shifting existing
midwives' roles. We included a detailed log of who had provided care
for women in the caseload scheme and for how long, to check that
hospital staff were not finding an additional burden of work left to
them to pick up. We could not obtain costs for epidurals (use of which
were reduced) and costs of medical staff were not considered part of
the relevant budget. Antenatal admissions and lengths of hospital stay
plus use of hospital clinics were reduced. The caseload midwives were
paid more and received a supplement for unsocial hours, and there were
associated community costs but they were more efficient economically
than other staff since they worked around the needs of their caseload,
thus balancing the apparent additional costs.
The general assumption seems to be that such schemes are bound to be
more expensive but perhaps we don't consider how wasteful of people's
energy and resources some systems may be. Certainly, much more research
is needed but we hope you find this study informative.
We have undertaken a follow-up study of this caseload scheme to see how
things look after the first few years. data are currently being
analysed and we plan to submit our longitudinal findings to a journal
when this is complete.
If you (or any else) need more info, please contact me by personal
E-mail.
Christine McCourt
On Tue, 9 Nov 1999 23:53:45 -0000 Ishbel Kargar
<[log in to unmask]> wrote:
>
> -----Original Message-----
> From: Squelch <[log in to unmask]>
> To: [log in to unmask] <[log in to unmask]>
> Date: 09 November 1999 21:35
> Subject: Iceni & Valley Midwifery Group Practices
>
>
>
>
> My local Health Authority has recently announced that it is planning to discontinue the above community based practices. Our area (Valley) has a 20% home birth rate, very little use of epidurals, 85% of women are delivered by a midwife known to them with fewer interventions and more mums breastfeed. The HE say that they cannot find £90,000 to run the scheme across the whole area and therefore in fairness to everyone we have to lose these practices!
>
> I'm trying to find information, particulary regarding costs, to show that these schemes save money. If it had not been for my Midwife checking on me each day of the last three weeks of my pregnancy, I would have probably spent them in hospital.
>
> Please could you let me know where I can find out the following:
>
> Cost of an epidural.
> Cost of keeping a patient in hospital for 24 hours
> Cost of a C-section
> Cost of Pethadin
>
> If you cannot help in this matter - I'm sorry to have taken up your time - our midwives really our too good to lose and I want to do all that I can to keep this brilliant system.
>
> Thank you
>
> Rachael Haylock
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