Regionalised Maternity Care - Is There Room For Improvement?
Funder
National Health and Medical Research Council
Funding Amount
$467,752.00
Summary
A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the ....A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the pool of women with existing medical conditions and risk factors for adverse pregnancy outcomes. There is an urgent need to identify risk-appropriate levels of maternity care based on women's antenatal conditions and risk factors that can be identified early or during pregnancy. The project will use existing population health data sets to determine to what extent regionalised maternity care is delivering women and their babies in risk-appropriate settings or whether there is room for improvement through increased transfer of at-risk pregnancies to higher levels of care. Variations in outcomes for mothers and babies may be due to factors that occur before or during pregnancy, or may be due to differences in the level of maternity care provided. We need to take account of maternal factors to fairly assess the role of the level of maternity care. To do this our project will develop and utilise innovative statistical techniques to look at the risk factors associated with poor outcomes (severe illness or death) for mothers and their babies. We will then be able to 'predict' outcomes and see if differences between levels of maternity care are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of maternity services. Results could be applied to direct health services policy and organisational changes to improve maternity care and optimise pregnancy outcomes for a healthy start to life.Read moreRead less
Does Place Of Birth Influence A Healthy Start To Life?
Funder
National Health and Medical Research Council
Funding Amount
$343,050.00
Summary
There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Austra ....There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Australian studies have looked at infant outcomes based on place of birth. This study will use existing population health data sets to evaluate the provision of care prior to and at birth and the impact it has on infant outcomes up to one year of age. It will also describe for the first time the hospital care utilisation associated with birth and infant health. Information will be obtained from routinely-collected birth, death and birth defect registers, and hospital, midwives and perinatal death review data. Variations in health outcomes for babies may be due to factors that occur before or during pregnancy, or may be due to differences in the care provided at birth. We need to take account of maternal factors to comprehensively assess the role of level of care at birth. We will use statistical techniques to 'predict' infant health outcomes and see if differences between places of birth are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of pregnancy and newborn services. We will also compare the benefits and consequences of maternal versus neonatal transfer, and assess hospital costs. The results of this study could be applied to direct health services policy and organisational changes to improve pregnancy care and optimise infant outcomes for a healthy start to life.Read moreRead less
1+1- A Healthy Start To Life:Targeting The Year Before And The Year After Birth In Aboriginal Children In Remote Areas
Funder
National Health and Medical Research Council
Funding Amount
$587,272.00
Summary
Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential ....Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential for promoting health and providing quality care. Evidence suggests redesigned models based on continuity of care, focused, proactive family support and workload reform will improve maternal and infant outcomes. New models need to be developed, costed, implemented and evaluated providing governments with the evidence base to initiate service improvement. Such models will have applicability elsewhere in Australia. Professor Lesley Barclay and her team of researchers from Charles Darwin University will conduct research into developing such a model. The project aims to improve the quality of care for remote dwelling Aboriginal women and infants in the year before, during and the year after birth by providing evidence for, and facilitating changes to, service delivery. This will enhance the potential for the development of resilience and well-being of their children. It will also test if service improvements can improve the health of women and reduce childhood disease and therefore reduce the impact of health conditions occurring in adulthood which have their origins in the early stages of life.Read moreRead less