TY - JOUR
T1 - Models of Risk Selection in Maternal and Newborn Care
T2 - Exploring the Organization of Tasks and Responsibilities of Primary Care Midwives and Obstetricians in Risk Selection across The Netherlands
AU - Goodarzi, Bahareh
AU - Verhoeven, Corine
AU - Berks, Durk
AU - de Vries, Eline F.
AU - de Jonge, Ank
N1 - Funding Information: We thank Elisa Oomen for helping us with the questionnaire. We thank the Midwifery Academies, Perined data register, and the College for Perinatal Care for providing us with an overview of primary midwifery care practices. We thank Lilian Peters, the College for Perinatal Care, the Federation of Maternity Care Collaborations, the Child and Hospital Foundation, the Dutch Society of Obstetrics and Gynecology, the Royal Dutch Organization of Midwives, and Hajo Wildschut for providing feedback on the questionnaire, and the primary care midwives, hospital-based midwives, and research assistants for pilot testing the questionnaire. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - An effective system of risk selection is a global necessity to ensure women and children receive appropriate care at the right time and at the right place. To gain more insight into the existing models of risk selection (MRS), we explored the distribution of different MRS across regions in The Netherlands, and examined the relation between MRS and primary care midwives’ and obstetricians’ satisfaction with different MRS. We conducted a nationwide survey amongst all primary midwifery care practices and obstetrics departments. The questionnaire was completed by 312 (55%) primary midwifery care practices and 53 (72%) obstetrics departments. We identified three MRS, which were distributed differently across regions: (1) primary care midwives assess risk and initiate a consultation or transfer of care without discussing this first with the obstetrician, (2) primary care midwives assess risk and make decisions about consultation or transfer care collaboratively with obstetricians, and (3) models with other characteristics. Across these MRS, variations exist in several aspects, including the routine involvement of the obstetrician in the care of healthy pregnant women. We found no significant difference between MRS and professionals’ level of satisfaction. An evidence-and value-based approach is recommended in the pursuit of the optimal organization of risk selection. This requires further research into associations between MRS and maternal and perinatal outcomes, professional payment methods, resource allocation, and the experiences of women and care professionals.
AB - An effective system of risk selection is a global necessity to ensure women and children receive appropriate care at the right time and at the right place. To gain more insight into the existing models of risk selection (MRS), we explored the distribution of different MRS across regions in The Netherlands, and examined the relation between MRS and primary care midwives’ and obstetricians’ satisfaction with different MRS. We conducted a nationwide survey amongst all primary midwifery care practices and obstetrics departments. The questionnaire was completed by 312 (55%) primary midwifery care practices and 53 (72%) obstetrics departments. We identified three MRS, which were distributed differently across regions: (1) primary care midwives assess risk and initiate a consultation or transfer of care without discussing this first with the obstetrician, (2) primary care midwives assess risk and make decisions about consultation or transfer care collaboratively with obstetricians, and (3) models with other characteristics. Across these MRS, variations exist in several aspects, including the routine involvement of the obstetrician in the care of healthy pregnant women. We found no significant difference between MRS and professionals’ level of satisfaction. An evidence-and value-based approach is recommended in the pursuit of the optimal organization of risk selection. This requires further research into associations between MRS and maternal and perinatal outcomes, professional payment methods, resource allocation, and the experiences of women and care professionals.
KW - Decision-making
KW - Healthcare organization
KW - Maternal and newborn care
KW - Risk selection
KW - Value-based healthcare
UR - http://www.scopus.com/inward/record.url?scp=85122848539&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/ijerph19031046
DO - https://doi.org/10.3390/ijerph19031046
M3 - Article
C2 - 35162069
SN - 1660-4601
VL - 19
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 3
M1 - 1046
ER -