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Does general practitioner involvement in commissioning maternity care make a difference?

S Wyke1, J Hewison, R Elton

  • 1Primary Care Research Group, University of Edinburgh, Edinburgh, UK.

Journal of Health Services Research & Policy
|May 19, 2001
PubMed
Summary
This summary is machine-generated.

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General practitioners commissioning maternity services did not improve women's care experiences or resource use. Strong national policy and healthcare professionals translating policy locally appear more influential than primary care commissioning alone.

Area of Science:

  • Health Services Research
  • Maternal Health
  • Primary Care Management

Background:

  • General practitioners (GPs) are increasingly involved in commissioning healthcare services.
  • The impact of GP commissioning on the quality and efficiency of maternity care requires evaluation.

Purpose of the Study:

  • To assess the effect of GP commissioning of maternity services on patient experience and resource utilization.
  • To explore implications for primary care commissioning strategies.

Main Methods:

  • Comparative study of 11 commissioning and 10 non-commissioning GP practices.
  • Interviews with 212 healthcare staff regarding maternity care organization (1996-1998).
  • Post-partum questionnaires to 1957 women assessing experiences and resource use, analyzed with multi-level modeling.

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Main Results:

  • No significant differences in women's care experiences or resource use were found between commissioning and non-commissioning practices.
  • Commissioning practices showed a trend towards more vertically integrated service models.
  • Minor differences in specific aspects of care experience were observed across different organizational models.

Conclusions:

  • GP commissioning of maternity services does not automatically lead to improved patient experiences or resource efficiency.
  • The influence of national policy and the effective local implementation by healthcare professionals are critical factors.
  • Organizational models alone are not sufficient indicators of care quality.