Caseload Midwifery For Women At Low Risk Of Medical Complications: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$604,527.00
Summary
In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing ....In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing caseload care. Studies of continuity of midwifery teams have reported reduced caesareans and other interventions in labour. They have also found increased satisfaction, with no statistically significant differences in health outcomes for babies. Women who are identified at low medical risk will be recruited from the antenatal clinic of a large, tertiary, public maternity hospital. Women will be randomly allocated to caseload midwifery or standard low risk care. Those allocated to caseload will receive pregnancy, birth and postnatal care from a primary midwife with one or two pregnancy visits to be conducted by a 'back-up' midwife. The midwife will collaborate with obstetricians and other health professionals as necessary. This will be the first RCT of caseload midwifery care in Australia and only the third one conducted anywhere. It is a unique opportunity to provide a rigorous evaluation of a model that is beginning to be implemented widely in Australia. The trial will provide much needed information regarding the outcomes of caseload midwifery including interventions in childbirth, safety, costs, women's satisfaction with care and impact on the midwifery workforce. The study will provide data that will inform clinical practice and guide service providers involved in the organisation of maternity services.Read moreRead less
Economic Evaluation And Health Outcomes Of Arthritis And Its Treatments
Funder
National Health and Medical Research Council
Funding Amount
$360,660.00
Summary
Musculoskeletal diseases are the most common single cause of chronic disability in Australia and total joint replacement is rapidly becoming one of the most commonly performed operations. This burden of illness is likely to increase with our ageing population and there is an urgent need to obtain data relating to the costs and outcomes in the Australian context so that appropriate planning of health services and resources can be carried out. The WHO (World Health Organisation) has declared 2000 ....Musculoskeletal diseases are the most common single cause of chronic disability in Australia and total joint replacement is rapidly becoming one of the most commonly performed operations. This burden of illness is likely to increase with our ageing population and there is an urgent need to obtain data relating to the costs and outcomes in the Australian context so that appropriate planning of health services and resources can be carried out. The WHO (World Health Organisation) has declared 2000 to 2010 the Bone and Joint Decade, recommending that research into musculoskeletal disorders be a priority. We have been recruiting and following a unique cohort of osteoarthritis and rheumatoid arthritis patients, from both the public and private health sectors, who have been carefully documenting their health outcomes, health care costs (including primary, revision and bilateral hip and knee joint replacement surgery), out-of-pocket and indirect costs related to their arthritis. Long-term follow-up is now essential to obtain a clear picture of the impact of living with arthritis over time and the cost-effectiveness and predictors of good and bad outcomes of joint replacement surgery. The information derived from this study will be useful for patients and doctors in making their decisions about treatments, as well as for health care providers in planning of health services for arthritis sufferers. Given that the cohorts are already established, the study is in a unique position to provide ongoing important longer-term data for relatively low cost.Read moreRead less