title: A cost-consequences analysis of a midwifery group practice for Aboriginal mothers and infants in the top end of the Northern Territory, Australia.
abstract: OBJECTIVE
  to compare the cost-effectiveness of two models of service delivery: Midwifery Group Practice (MGP) and baseline cohort.
  
  
  METHODS
  a retrospective and prospective cohort study.
  
  
  METHODS
  a regional hospital in Northern Territory (NT), Australia.
  
  
  METHODS
  baseline cohort included all Aboriginal mothers (n=412), and their infants (n=416), from two remote communities who gave birth between 2004 and 2006. The MGP cohort included all Aboriginal mothers (n=310), and their infants (n=315), from seven communities who gave birth between 2009 and 2011. The baseline cohort mothers and infant's medical records were retrospectively audited and the MGP cohort data were prospectively collected. All the direct costs, from the Department of Health (DH) perspective, occurred from the first antenatal presentation to six weeks post partum for mothers and up to 28 days post births for infants were included for analysis.
  
  
  METHODS
  analysis was performed with SPSS 19.0 and Stata 12.1. Independent sample of t-tests and χ2 were conducted.
  
  
  RESULTS
  women receiving MGP care had significantly more antenatal care, more ultrasounds, were more likely to be admitted to hospital antenatally, and had more postnatal care in town. The MGP cohort had significantly reduced average length of stay for infants admitted to Special Care Nursery (SCN). There was no significant difference between the two cohorts for major birth outcomes such as mode of birth, preterm birth rate and low birth weight. Costs savings (mean A$703) were found, although these were not statistically significant, for women and their infants receiving MGP care compared to the baseline cohort.
  
  
  CONCLUSIONS
  for remote dwelling Aboriginal women of all risk who travelled to town for birth, MGP was likely to be cost effective, and women received better care and resulting in equivalent birth outcomes compared with the baseline maternity care.
authors.affiliation: University Centre for Rural Health North Coast, School of Public Health, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia. Electronic address: yu.gao@ucrh.edu.au.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Deakin Population Health SRC, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia. Electronic address: lisa.gold@deakin.edu.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gold
authors.affiliation: University Centre for Rural Health North Coast, School of Public Health, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia. Electronic address: cfar3313@uni.sydney.edu.au.
authors.forename: Cath
authors.initials: C
authors.lastname: Josif
authors.affiliation: University Centre for Rural Health North Coast, School of Public Health, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia. Electronic address: sbarzeev@mail.usyd.edu.au.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bar-Zeev
authors.affiliation: Life Course and Intergenerational Health Research Group (LIGHt), Discipline of Obstetrics and Gynaecology, Faculty of Health Sciences, The University of Adelaide, North Terrace, Adelaide SA 5005, Australia. Electronic address: malinda.steenkamp@adelaide.edu.au.
authors.forename: Malinda
authors.initials: M
authors.lastname: Steenkamp
authors.affiliation: University Centre for Rural Health North Coast, School of Public Health, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia. Electronic address: Lesley.barclay@sydney.edu.au.
authors.forename: Lesley
authors.initials: L
authors.lastname: Barclay
authors.affiliation: Health Gains Planning, Northern Territory Department of Health, Darwin, NT 0811, Australia. Electronic address: Yuejen.zhao@nt.gov.au.
authors.forename: Yuejen
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Sydney Nursing School, University of Sydney, Sydney, NSW 2006, Australia. Electronic address: stracy@ozemail.com.au.
authors.forename: Sally
authors.initials: S
authors.lastname: Tracy
authors.affiliation: Women's Health and Newborn Services, Australia Catholic University and Mater Mothers Hospital, Brisbane 4101, Australia. Electronic address: sue.kildea@acu.edu.au.
authors.forename: Sue
authors.initials: S
authors.lastname: Kildea
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services / Q000191:economics*; D008880:Midwifery / Q000191:economics* / Q000379:methods; D015876:Northern Territory / Q000453:epidemiology; D024802:Nurse's Role; D057184:Practice Patterns, Nurses' / Q000191:economics*; D011446:Prospective Studies; D019035:Rural Health Services / Q000191:economics*; D055815:Young Adult
keywords: Australia; Cost-consequences analysis; Indigenous; Midwifery Group Practice