Denise,
Perhaps Sally Tracy's paper on 'costing the cascade' will give us some figures to work with on this. But in the meantime it doesn't really matter since we can still say credibly to the media and governments that they stand to save AT LEAST $1,500 per birth by engaging midwives as lead carers.
And that is at a rate paid to midwives of $3,500 per birth - greater than most have been able to charge as IPMs 9intended to cover all their costs of contracting like vehichle, superannuation, etc). That amount could also cover PI insurance if it were in the market to be bought. Given that it's not, we're pushing the ACT government to provide vicarious liability to contracted midwives.
regards Barb.
From: "Denise Hynd" <[EMAIL PROTECTED]>
Date: Mon, 21 Jan 2002 08:10:16 +0800
To: "Vernon at Stringybark" <[EMAIL PROTECTED]>, "ozmid" <[EMAIL PROTECTED]>
Subject: Re: Calculating savings from midwife led care
Dear Barb
Thank you for that I agree you probably have under estimated particularly as you many interventions have complications and even with out them many have extras like the obs who put the c/s women on a/b and many then have secondary infections, or the babies who have temps in labour due to epidurals get put on a/bs or feed poorly and have other cascades of interventions then there ar the trips to nurseries for babies of difficult deliveries.
I have also seen some HlthDept DRG costings for 3 different catgories of C/s (which unfortunately I lost).
But this again all says to those with working ears the current system is ineffective!
Denise
----- Original Message -----
From: Vernon at Stringybark <mailto:[EMAIL PROTECTED]>
To: ozmid <mailto:[EMAIL PROTECTED]>
Sent: Monday, January 21, 2002 7:12 AM
Subject: Calculating savings from midwife led care
Denise,
The figures quoted were worked out by Justine and I using a range of sources (including information provided by Sally Tracy from AMAP). I am happy to email you the page we used to estimate the ACT figures as an attachment. Also happy to send to anyone else who is interested.
We have run these figures past a host of people in the ACT hospital system and in government. no-one has contested them at all. Indeed, they have agreed to our argument that the figures are likely to be an underestimate.
The quick formula used is as follows:
Average cost of a caesarean section is $3,000 for the surgery, plus $500 per day for hospital stay. Caesarean usually requires 5 days post op stay so that is $2,500 for the stay. total then for casesarean of $5,500 per woman. Multiply this by 20% of the total number of births in the State of interest because national caesarean rate is currently around 20%.
Then look at non-caesarean births. We don't have good data available on the costs of various types of intervention (pending the publciation by Sally Tracy of her paper on Costing the Cascade - due out soon. So we simply assumed no interventions - normal vaginal delivery in hospital. Sally Tracy advises us that a realistic figure for this is $1,800 plus 4 days hospital stay at $500 per day = $2,000 for the stay. 4 days stay is the national post birth average for length of stay. So that makes $3,800 for the normal births. Obviously not many births are 'normal' ie no intervnetion. So the real costs of the 80% would be quite a bit higher. But this estimate is defensible given the information available at present.
We then mooted a cost per birth by comparison of $3,500 per birth for a total package of midwife-led care 9including antnatal, birth and postnatal care), contracted by the government. originally we facotred in a 5% caesarean rate, based on figures of transfer rates for independent practices. Again this was on the high side to make the estimate solid.
So when you work all this out on a model of 120 births you get a saving of around $1,500 per birth that is handled by midwives instead of acute services. simply multiply that by various percentages of the numbers of births in your state to get some impressive savings for media headlines!!!
Hope you can follow this. As I said, I'll email you the calculations and sources as an attachment.
regards Barb
Dr Barbara Vernon
National president
Maternity Coalition
From: "Denise Hynd" <[EMAIL PROTECTED]>
Date: Sun, 20 Jan 2002 10:39:44 +0800
To: <[EMAIL PROTECTED]>, "Annyce Pidd" <[EMAIL PROTECTED]>
Subject: Re: Canberra Times Letter
Great article and headline !
Though it led me to wonder
If these are the figures for ACT at only 5% accessing midwifery care saves $1.4mil
Does it follow then if 50% accessed midwifery led care would the savings be $14 mil or 80% = $22.4mil or 100% =$28mil??
Now that savings might equal the cost of U/S??
How were the savings figures determined (what is the balanced cost of midwifery led care?) so we can apply the formula to the birth statistics of each state??
For example WA has 25,000 births pa
Denise
----- Original Message -----
From: Annyce Pidd <mailto:[EMAIL PROTECTED]>
To: Denise Hynd <mailto:[EMAIL PROTECTED]>
Sent: Saturday, January 19, 2002 6:33 PM
Subject: Re: Canberra Times Letter
Call for boost to midwife-led births
By DANIELLE CRONIN
Taxpayers would be spared about $1.4 million annually in medical bills if midwife-led childbirths were boosted in the ACT, a maternity lobby group said yesterday.
Maternity Coalition ACT spokeswoman Justine Caines said about 5000 women from the ACT and region gave birth in the past year, with 5 per cent accessing one-on-one midwife care.
It would save about $1.4 million through reductions in medical procedures such as elective caesarean sections and epidurals if the one-on-one midwife care was increased to 20 per cent, Ms Caines said.
The Maternity Coalition met Health Minister Jon Stanhope this week to discuss midwifery services in the ACT.
The organisation called for 120 more places in the Canberra Midwifery Program and Birth Centre which cared for more than 500 pregnant women in the past year.
Up to 14 women were turned away from the Canberra Midwifery Program a month but an extra 120 places would help keep pace with demand. Ms Caines said the Government could divert funds from other hospital maternity programs and contract independent midwives to take on case loads.
Ms Caines said the Maternity Coalition received a fair hearing from Mr Stanhope who pledged to respond to their proposal within two weeks.
----- Original Message ---------- Original Message -----
From: Denise Hynd <mailto:[EMAIL PROTECTED]>
To: Vernon at Stringybark <mailto:[EMAIL PROTECTED]> ; ozmid <mailto:[EMAIL PROTECTED]>
Sent: Saturday, January 19, 2002 2:35 PM
Subject: Re: Canberra Times Letter
Dear Barb And all,
I think we need to beware of our despondant thinking
>but don't hold our breaths its will be all that enlightened.
3 letters and an article will inform some posibly many to look further before getting on the production line or it may also make some one in bureaucracy open their eyes & become informed or invloved??
Remember raindrops as they multiply can be part of a an all powerful strom which can move all in its path or if they fall to the ground and join a river can cause a flood which knocks out steel bridges!!
So come on all you raindrops come together, realise our combined power and create change!!
Denise
From: Vernon at Stringybark <mailto:[EMAIL PROTECTED]>
To: ozmid <mailto:[EMAIL PROTECTED]>
Sent: Friday, January 18, 2002 2:19 PM
Subject: Re: Canberra Times Letter
Born,
Justine's letter got into Tuesday's paper, and mine appeared on Thursday. I haven't seen today's paper to check if Tina's was there.
We have also contacted the Canberra Times editor and as a result he asked his health reporter, Danielle Cronin, to do a piece in Saturday's(tomorrow's) paper. She has filed a news item on the Maternity Coalition meeting with the ACT Chief Minister yesterday as well as an opinion piece. We shall look forward to see what she produces but don't hold our breaths its will be all that enlightened.
regards Barb.
From: "Steve & Bronni McGrath" <[EMAIL PROTECTED]>
Date: Fri, 18 Jan 2002 01:04:18 +1100
To: "list" <[EMAIL PROTECTED]>
Subject: Canberra Times Letter
To Justine, Barbara and Tina congratulations on your wonderful work, I would love to know if you were published. Bronni
