The value of maternity care in Queensland, 2012–18, based on an analysis of administrative data: a retrospective observational study

Emily J Callander, Joanne C Enticott, Bonnie Eklom, Jenny Gamble, Helena J Teede

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Abstract

Objective: To quantify the value of maternity health care — the relationship of outcomes to costs — in Queensland during 2012–18. Study design: Retrospective observational study; analysis of Queensland Perinatal Data Collection data linked with the Queensland Health Admitted Patient, Non‐Admitted Patient, and Emergency Data Collections, and with the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) databases. Setting, participants: All births in Queensland during 1 July 2012 – 30 June 2018. Main outcome measures: Maternity care costs per birth (reported in 2021–22 Australian dollars), both overall and by funder type (public hospital funders, MBS, PBS, private health insurers, out‐of‐pocket costs); value of care, defined as total cost per positive birth outcome (composite measure). Results: The mean cost per birth (all funders) increased from $20 471 (standard deviation [SD], $17 513) during the second half of 2012 to $30 000 (SD, $22 323) during the first half of 2018; the annual total costs for all births increased from $1.31 billion to $1.84 billion, despite a slight decline in the total number of births. In a mixed effects linear analysis adjusted for demographic, clinical, and birth characteristics, the mean total cost per birth in the second half of 2018 was $9493 higher (99.9% confidence interval, $8930–10 056) than during the first half of 2012. The proportion of births that did not satisfy our criteria for a positive birth outcome increased from 27.1% (8404 births) during the second half of 2012 to 30.5% (9041 births) during the first half of 2018. Conclusion: The costs of maternity care have increased in Queensland, and many adverse birth outcomes have become more frequent. Broad clinical collaboration, effective prevention and treatment strategies, as well as maternal health services focused on all dimensions of value, are needed to ensure the quality and viability of maternity care in Australia.
Original languageEnglish
Pages (from-to)535-541
Number of pages7
JournalMedical Journal of Australia
Volume219
Issue number11
Early online date8 Nov 2023
DOIs
Publication statusE-pub ahead of print - 8 Nov 2023

Bibliographical note

© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Funder

National Health and Medical Research Council
Open access publishing facilitated by University of Technology Sydney, as part of the Wiley - University of Technology Sydney agreement via the Council of Australian University Librarians.

Keywords

  • Maternal health
  • Perinatal
  • Pregnancy
  • Health services research
  • Health financing
  • Financial management
  • Economics
  • medical

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