Abstract
The introduction of bundled payment for maternity care, aimed at improving the quality of maternity care, may affect pregnant women's choice in providers of maternity care. This paper describes a Dutch study which examined pregnant women's preferences when choosing a maternity care provider. The study focused on factors that enhance the quality of maternity care versus (restricted) provider choice. A discrete choice experiment was conducted amongst 611 pregnant women living in the Netherlands using an online questionnaire. The data were analysed with Latent Class Analyses. The outcome measure consisted of stated preferences in the discrete choice experiment. Included factors were: information exchange by care providers through electronic medical records, information provided by midwife, information provided by friends, freedom to choose maternity care provider and travel distance. Four different preference structures were found. In two of those structures, respondents found aspects of the maternity care related to quality of care more important than being able to choose a provider (provider choice). In the two other preference structures, respondents found provider choice more important than aspects related to quality of maternity care. In a country with presumed high-quality maternity care like the Netherlands, about half of pregnant women prefer being able to choose their maternity care provider over organisational factors that might imply better quality of care. A comparable amount of women find quality-related aspects most important when choosing a maternity care provider and are willing to accept limitations in their choice of provider. These insights are relevant for policy makers in order to be able to design a bundled payment model which justify the preferences of all pregnant women.
Highlights
In many countries, payment reforms are seen as a major lever to achieve new models of care delivery including improved care coordination and multidisciplinary collaboration amongst providers [1,2,3]
Included factors were: information exchange by care providers through electronic medical records, information provided by midwife, information provided by friends, freedom to choose maternity care provider and travel distance
The largest Class Assignment Probabilities (CAP) is 0.29 and the lowest of the four is 0.21 (Table 2), which indicates that the classes are evenly distributed and that respondents have about a one in four chance to belong to one of the classes
Summary
Payment reforms are seen as a major lever to achieve new models of care delivery including improved care coordination and multidisciplinary collaboration amongst providers [1,2,3]. The rationale behind payment models such as bundled payment is that they incentivize care coordination, and stimulate the use of high-quality care by increased provider accountability. Bundled payment models align financial incentives with desired health outcomes and spending and by doing so aim to motivate providers to deliver high quality of care [3]. Positive consequences included quality improvements in care delivery processes and in the transparency of delivered care. The introduction of bundled payment for maternity care, aimed at improving the quality of maternity care, may affect pregnant women’s choice in providers of maternity care.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
