Long-term cost savings with Centering-based group antenatal care

Area of Science:

• Maternal Health
• Healthcare Economics
• Public Health Interventions

Background:

• Group antenatal care (gANC) integrates routine care, education, and community support, demonstrating positive perinatal outcomes.
• Dutch midwives report higher costs associated with providing gANC compared to individual care (IC).

Purpose of the Study:

• To evaluate the impact of substituting individual care (IC) with group antenatal care (gANC) on future healthcare costs and health outcomes.
• To conduct a cost-benefit analysis comparing gANC and IC.

Main Methods:

• An exploratory cost-benefit analysis was conducted using a hypothetical cohort of 12,894 women.
• Data originated from a stepped wedge cluster randomized controlled trial in the Netherlands, literature review, and midwifery practice surveys.
• The primary outcome measured was the differential cost and lifetime direct healthcare costs associated with gANC versus IC.

Main Results:

• gANC incurred an additional differential cost of €45 per participant compared to IC.
• Projected healthcare cost savings were observed, driven by increased breastfeeding rates, reduced pregnancy-induced hypertension, and decreased postpartum smoking.
• An average net cost saving of €67 per participant was estimated for gANC.

Conclusions:

• gANC demonstrates superior health and psychosocial outcomes compared to IC, although it involves higher initial provision costs.
• The findings suggest that the initial higher costs of gANC are compensated by long-term healthcare cost savings.