Related Experiment Video
Updated: Jul 27, 2025
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis
Yu Gao1,2, Yvette Roe1,2, Sophie Hickey1,2
1Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland, 4000, Australia.
Insights
The Birthing in Our Community (BiOC) service significantly reduced preterm births and saved costs for First Nations families in Australia. This community-led model of care is a cost-effective alternative to standard care.
Area of Science:
- Maternal and Child Health
- Health Economics
- Indigenous Health
Background:
- Preterm birth is a major cause of infant mortality, with First Nations babies in Australia facing disproportionately higher rates.
- The Birthing in Our Community (BiOC) service was implemented to address this disparity and has shown promise in reducing preterm births.
Purpose of the Study:
- To evaluate the cost-effectiveness of the BiOC service compared to Standard Care in reducing preterm births among First Nations families.
- To analyze direct healthcare costs from a health system perspective.
Main Methods:
- A comparative study was conducted at Mater Mothers Public Hospital, Brisbane, involving First Nations mothers and babies.
- Data on antenatal, birth, postnatal, and neonatal care costs were collected from January 2013 to June 2019.
- Inverse probability of treatment weighting was used to adjust for differences between the BiOC and Standard Care groups.
Main Results:
- The BiOC service was associated with a 5.34% reduction in preterm birth rates compared to Standard Care.
- The BiOC service resulted in cost savings of AU$4810 per mother-baby pair.
- These findings indicate better outcomes and lower costs with the BiOC service.
Conclusions:
- The BiOC service presents a cost-effective strategy for reducing preterm birth in Australian First Nations populations.
- Cost savings were attributed to reduced interventions, procedures, and neonatal admissions.
- Investing in community-led, comprehensive care models can improve health outcomes while reducing costs.
Background:
Preterm birth is the leading cause of morbidity and mortality for children under five years with First Nations babies experiencing twice the rate of other Australians. The Birthing in Our Community (BiOC) service was implemented in a metropolitan centre in Australia and showed a significant reduction in preterm birth. We aimed to assess the cost-effectiveness of the BiOC service in reducing preterm births compared to Standard Care, from a health system perspective.
Methods:
Women who were carrying a First Nations baby and attending the Mater Mothers Public Hospital (Brisbane, QLD, Australia) were allocated to either BiOC or Standard Care service. Birth records were extracted from the hospital's routinely collected and prospectively entered database. The time horizon extended from first presentation in pregnancy up to six weeks after birth for mothers and 28 days for infants, or until discharged from hospital. All direct antenatal, birth, postnatal and neonatal costs were included. The proportion of preterm birth was calculated, and cost was estimated in 2019 Australian dollars. The incremental cost and proportion of preterm birth differences were adjusted using inverse probability of treatment weighting methods.
Findings:
Between Jan 1 2013, and Jun 30, 2019, 1816 mothers gave births to 1867 First Nations babies at the Mater Mothers Public Hospital. After exclusions, 1636 mother-baby pairs were included in the analyses: 840 in the Standard Care group and 796 in the BiOC service. Relative to Standard Care, the BiOC service was associated with a reduced proportion of preterm birth (-5.34%, [95% CI -8.69%, -1.98%]) and cost savings (-AU$4810, [95% CI -7519, -2101]) per mother-baby pair. The BiOC service was associated with better outcomes and cost less than Standard Care.
Interpretation:
The BiOC service offers a cost-effective alternative to Standard Care in reducing preterm birth for Australian First Nations families. The cost savings were driven by less interventions and procedures in birth and fewer neonatal admissions. Investing in comprehensive, community-led models of care improves outcomes at reduced cost.
Funding:
The Australian National Health and Medical Research Council (APP1077036).
More Related Videos
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:26Traditional Level Of Health Care System
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...