A birthing service established by three South East Queensland health organisations has reduced preterm birth rates for Aboriginal and Torres Strait Islander babies by 38% and demonstrated significant cost savings to the health system.
Results published in the Lancet Regional Health – Western Pacific this week highlighted improved outcomes for women having a baby through the Birthing in Our Community service. The reduction in preterm birth rates meant that women accessing the program required fewer costly interventions, procedures and neonatal admissions, resulting in savings of $4,810 per mother/baby pair. Additionally, the BiOC service reduced two thirds of women’s out of pocket costs by bringing the service closer to home.
The cost-effectiveness study concluded that replication of the Birthing in Our Community service across Australia has the potential to reduce the number of Aboriginal and Torres Strait Islander babies born preterm by 965 each year, thereby potentially saving the Australian health system $86,994,021 per annum.
The Birthing in Our Community service and model of care was established in 2013 by the Institute for Urban Indigenous Health (IUIH), the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane and Mater Health in Brisbane in response to a need for women who are pregnant with an Aboriginal and/or Torres Strait Islander baby to access culturally and clinically safe care throughout their pregnancy and at birth.
Ms Renee Blackman, ATSICHS Brisbane CEO, said that “the success of the Birthing in Our Community service shows what can be achieved when partners work together with a shared vision and a commitment to Aboriginal-led models of care”.
“Investing in developing an Indigenous workforce to support women has been key to keeping women engaged in the program and also supports employment opportunities for Aboriginal and Torres Strait Islander people in the region”, she said. “Every mum at Birthing in Our Community gets their own midwife 24/7 working side by side with a multidisciplinary workforce to make sure all our women feel confident and safe to access the care they need for themselves and their bub”.
Lead researcher, Professor Sue Kildea, said the results from the BiOC service are unprecedented. “Knowing that nationally the preterm rates for First Nations babies have not reduced since Close the Gap was announced in 2008, it is extraordinary to see a 38% reduction,” she said. ‘When a cost-effectiveness lens is applied, the economic impact is also considerable”.
IUIH CEO, Adrian Carson, said that the improved outcomes demonstrate the success of Aboriginal community controlled health services (CCHSs) leading system reform with mainstream maternity services. “The CCHS sector has long advocated that models of care specifically designed for First Nations people and delivered by CCHSs can achieve better outcomes for our people be more cost-effective. This research provides strong evidence for replication of this service model across Australia,” Mr Carson said.
Mr Carson said, “the model is achieving preterm birth rates for First Nations families that are better than those achieved by the Australian health system for the general population. Supporting its expansion makes sense from both a healthcare delivery and economic perspective, and I would like to see the savings generated from the model reinvested into the establishment of more Birthing in Our Community services across Australia.”
The service is First Nations led, culturally responsive, clinically and cost effective and popular with all stakeholders. Such a model has the potential to address much needed reform in the Australian health system and improve birth outcomes for First Nations mothers and babies in Australia with significant cost benefits.
The full article, Birthing on Country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective study, can be found at: https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(23)00040-8/fulltext
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