Cost of maternity care to public hospitals: A first 1000-days perspective from Queensland

Emily J. Callander, Jennifer Fenwick, Roslyn Donnellan-Fernandez, Jocelyn Toohill, Debra K. Creedy, Jenny Gamble, Haylee Fox, David Ellwood

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
31 Downloads (Pure)


Objective: This study sought to compare costs for women giving birth in different public hospital services across Queensland and their babies. Methods: A whole-of-population linked administrative dataset was used containing all health service use in a public hospital in Queensland for women who gave birth between 1 July 2012 and 30 June 2015 and their babies. Generalised linear models were used to compare costs over the first 1000 days between hospital and health services. Results: The mean unadjusted cost for each woman and her baby (n = 134 910) was A$17406 in the first 1000 days. After adjusting for clinical and demographic factors and birth type, women and their babies who birthed in the Cairns Hospital and Health Service (HHS) had costs 19% lower than those who birthed in Gold Coast HHS (95% confidence interval (CI) -32%, -4%); women and their babies who birthed at the Mater public hospitals had costs 28% higher than those who birthed at Gold Coast HHS (95% CI 8, 51). Conclusions: There was considerable variation in costs between hospital and health services in Queensland for the costs of delivering maternity care. Cost needs to be considered as an important additional element of monitoring programs. What is known about the topic?: The Australian maternal care system delivers high-quality, safe care to Australian mothers. However, this comes at a considerable financial cost to the Australian public health system. It is known that there are variations in the cost of care depending upon the model of care a woman receives, and the type of delivery she has, with higher-cost treatment not necessarily being safer or producing better outcomes. What does this paper add?: This paper compares the cost of delivering a full cycle of maternity care to a woman at different HHSs across Queensland. It demonstrates that there is considerable variation in cost across HHSs, even after adjusting for clinical and demographic factors. What are the implications for practitioners?: Reporting of cost should be an ongoing part of performance monitoring in public hospital maternity care alongside clinical outcomes to ensure the sustainability of the high-quality maternal health care Australian public hospitals deliver.

Original languageEnglish
Pages (from-to)556-564
Number of pages9
JournalAustralian Health Review
Issue number5
Publication statusPublished - 15 Jul 2019
Externally publishedYes

Bibliographical note

Open Access CC BY-NC-ND


Funding Information:
The creation of the Maternity1000 dataset was gratefully received from the Australian Institute of Tropical Health and Medicine, StillbirthCRE and the Griffith School of Nursing and Midwifery. E. J. Callander receives salary support under an Australian National Health and Medical Research Council Career Development Fellowship (APP1159536).


  • data linkage
  • efficiency
  • maternity services
  • performance monitoring
  • perinatal care
  • postpartum
  • pregnancy

ASJC Scopus subject areas

  • Health Policy


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