Remaining patient sample IHPA considered that the remaining sample of approximately 60,000 maternity patients across Australia provided a robust data set for reaching conclusions regarding service delivery patterns for maternity care and for developing an indicative bundled pricing approach. useful for the purposes of gaining a clearer picture of service delivery patterns, IHPA acknowledges that the data approach is not robust enough to be used for Commonwealth funding purposes for public hospital services as it would not allow for a fully accurate reconciliation of activity against each patient to prevent double payments. 4. Provision of maternity care This chapter discusses the delivery of maternity services in Australian public hospitals as analysed using public hospital data and implications for developing a bundled pricing approach. 4.1 Overview of maternity care Routine maternity care covers antenatal care from approximately ten weeks gestation, which is the first scheduled appointment, to postnatal care which ends six weeks after the birth episode. It spans multiple settings of care, including the non-admitted setting for antenatal and postnatal care, the admitted acute setting for birth and potentially the emergency setting for some patients. Most mothers give birth in conventional labour wards, with a small proportion choosing birth centres, home births or giving birth before reaching the hospital. Maternity care is one of the leading causes of hospital admission in 2014-15 with approximately 360,000 admitted acute separations in public hospitals under the Major Diagnostic Category (MDC) for ‘Pregnancy, childbirth and the puerperium’. The DRGs for minor complexity vaginal delivery (O60C) and minor complexity caesarean delivery (O01C) were the third and eleventh highest volume DRGs respectively in public hospitals. There were 226,232 birth episodes in public hospitals in 2014-15 as reported in IHPA data. The AIHW reported 307,844 women as giving birth in 2014, with 73% doing so in public hospitals. Vaginal births are the most common mode of birth for maternity patients, although caesarean births make up approximately 29% of the total as shown at Table 2. Table 2: Birth episodes by DRG, 2014-15 % of total Diagnosis Related Group Separations (rounded) O01A delivery, major complexity’ 7,556 3.3% – ‘Caesarean O01B delivery, intermediate complexity’ 28,180 12.5% – ‘Caesarean O01C delivery, complexity’ 30,933 13.7% – ‘Caesarean
Remaining patient sample IHPA considered that the remaining sample of approximately 60,000 maternity patients across Australia provided a robust data set for reaching conclusions regarding service delivery patterns for maternity care and for developing an indicative bundled pricing approach. useful for the purposes of gaining a clearer picture of service delivery patterns, IHPA acknowledges that the data approach is not robust enough to be used for Commonwealth funding purposes for public hospital services as it would not allow for a fully accurate reconciliation of activity against each patient to prevent double payments. 4. Provision of maternity care This chapter discusses the delivery of maternity services in Australian public hospitals as analysed using public hospital data and implications for developing a bundled pricing approach. 4.1 Overview of maternity care Routine maternity care covers antenatal care from approximately ten weeks gestation, which is the first scheduled appointment, to postnatal care which ends six weeks after the birth episode. It spans multiple settings of care, including the non-admitted setting for antenatal and postnatal care, the admitted acute setting for birth and potentially the emergency setting for some patients. Most mothers give birth in conventional labour wards, with a small proportion choosing birth centres, home births or giving birth before reaching the hospital. Maternity care is one of the leading causes of hospital admission in 2014-15 with approximately 360,000 admitted acute separations in public hospitals under the Major Diagnostic Category (MDC) for ‘Pregnancy, childbirth and the puerperium’. The DRGs for minor complexity vaginal delivery (O60C) and minor complexity caesarean delivery (O01C) were the third and eleventh highest volume DRGs respectively in public hospitals. There were 226,232 birth episodes in public hospitals in 2014-15 as reported in IHPA data. The AIHW reported 307,844 women as giving birth in 2014, with 73% doing so in public hospitals. Vaginal births are the most common mode of birth for maternity patients, although caesarean births make up approximately 29% of the total as shown at Table 2. Table 2: Birth episodes by DRG, 2014-15 Diagnosis Related Group Separations % of total (rounded) O01A – ‘Caesarean delivery, major complexity’ 7,556 3.3% O01B – ‘Caesarean delivery, intermediate complexity’ 28,180 12.5% O01C – ‘Caesarean delivery, complexity’ 30,933 13.7%
bundled_pricing_for_maternity_care_-_final_report.docx