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A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland

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  • Christopher G. Fawsitt

    (University of Bristol
    Cork University Business School, University College Cork
    University College Cork)

  • Jane Bourke

    (Cork University Business School, University College Cork)

  • Aileen Murphy

    (Cork University Business School, University College Cork)

  • Brendan McElroy

    (Cork University Business School, University College Cork)

  • Jennifer E. Lutomski

    (Radboud Institute for Health Sciences, Radboud University Medical Center)

  • Rosemary Murphy

    (Cork University Business School, University College Cork)

  • Richard A. Greene

    (University College Cork)

Abstract

Background The Irish government has committed to expand midwifery-led care alongside consultant-led care nationally, although very little is known about the potential net benefits of this reconfiguration. Objectives To formally compare the costs and benefits of the major models of care in Ireland, with a view to informing priority setting using the contingent valuation technique and cost-benefit analysis. Methods A marginal payment scale willingness-to-pay question was adopted from an ex ante perspective. 450 pregnant women were invited to participate in the study. Cost estimates were collected primarily, describing the average cost of a package of care. Net benefit estimates were calculated over a 1-year cycle using a third-party payer perspective. Results To avoid midwifery-led care, women were willing to pay €821.13 (95% CI 761.66–1150.41); to avoid consultant-led care, women were willing to pay €795.06 (95% CI 695.51–921.15). The average cost of a package of consultant- and midwifery-led care was €1,762.12 (95% CI 1496.73–2027.51) and €1018.47 (95% CI 916.61–1120.33), respectively. Midwifery-led care ranked as the best use of resources, generating a net benefit of €1491.22 (95% CI 989.35–1991.93), compared with €123.23 (95% CI −376.58 to 621.42) for consultant-led care. Conclusions While both models of care are cost-beneficial, the decision to provide both alternatives may be constrained by resource issues. If only one alternative can be implemented then midwifery-led care should be undertaken for low-risk women, leaving consultant-led care for high-risk women. However, pursuing one alternative contradicts a key objective of government policy, which seeks to improve maternal choice. Ideally, multiple alternatives should be pursued.

Suggested Citation

  • Christopher G. Fawsitt & Jane Bourke & Aileen Murphy & Brendan McElroy & Jennifer E. Lutomski & Rosemary Murphy & Richard A. Greene, 2017. "A Cost-Benefit Analysis of Two Alternative Models of Maternity Care in Ireland," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 785-794, December.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:6:d:10.1007_s40258-017-0344-8
    DOI: 10.1007/s40258-017-0344-8
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    References listed on IDEAS

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    1. Phil Shackley & Cam Donaldson, 2000. "Willingness to pay for publicly-financed health care: how should we use the numbers?," Applied Economics, Taylor & Francis Journals, vol. 32(15), pages 2015-2021.
    2. McIntosh, Emma & Clarke, Philip & Frew, Emma & Louviere, Jordan (ed.), 2010. "Applied Methods of Cost-Benefit Analysis in Health Care," OUP Catalogue, Oxford University Press, number 9780199237128, Decembrie.
    3. Andrew J Lloyd, 2003. "Threats to the estimation of benefit: are preference elicitation methods accurate?," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 393-402, May.
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    Cited by:

    1. Ali Darvishi & Reza Goudarzi & Viktoria Habib Zadeh & Mohsen Barouni, 2020. "Cost-benefit Analysis of IUI and IVF based on willingness to pay approach; case study: Iran," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-13, July.
    2. Stella Nalukwago Settumba & Marian Shanahan & Willings Botha & Muhammad Zulilhaam Ramli & Georgina Mary Chambers, 2019. "Reliability and Validity of the Contingent Valuation Method for Estimating Willingness to Pay: A Case of In Vitro Fertilisation," Applied Health Economics and Health Policy, Springer, vol. 17(1), pages 103-110, February.

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