Authors:
Einarsdóttir K, Stock S, Haggar F, Hammond G, Langridge AT, Preen DB, De Klerk N, Leonard H, Stanley FJ
Authors notes:
BMJ Open. 2013;3(5):e002786
Keywords:
Public hospitals, private hospitals, neonatal outcomes, pregnancy, mode of delivery
Abstract:
To use propensity score methods to create similar groups of women delivering in public and private hospitals and determine any differences in mode of delivery and neonatal outcomes between the matched groups.
No significant differences in maternal characteristics were found between the propensity scorematched groups.
Private patients were more likely than their matched public counterparts to undergo prelabour caesarean section (25.2% vs 18%).
Public patients had lower rates of neonatal unit admission and neonatal resuscitation, but higher rates of low Apgar scores at 5 min despite adjustment for antenatal factors.
Additional adjustment for mode of delivery reduced the resuscitation risk but did not significantly alter the other estimates.
Propensity score methods can be used to generate comparable groups of public and private patients.
Despite the rates of low Apgar scores being higher in public patients, the rates of special care admission were lower.
Whether these findings stem from differences in paediatric services or clinical factors is yet to be determined.