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BMC Health Services Research

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Open Access 01-12-2021 | Care | Research

Access-to-care: evidence from home-based postnatal coordinated care after hospital discharge

Authors: Saad Zbiri, Patrick Rozenberg, Carine Milcent

Published in: BMC Health Services Research | Issue 1/2021

Abstract

Background

Home-based postnatal care after hospital discharge has become an integral part of postnatal care. This study aimed to determine the factors relating either to individuals or the healthcare system that affect enrollment and full participation (adherence) in the French home-based postnatal coordinated care program (PRADO).

Methods

All admitted women for delivery in a French district over one year and eligible for this home-based midwifery support after hospital discharge were included (N = 4189). Both a simple probit model and a probit Heckman selection model were used. The control variables were the characteristics of the women, the municipalities, and the hospitals.

Results

Approximately 68% of the eligible women chose to enroll in the PRADO program, of who nearly 60% fully participated in this program. Enrollment in the program was influenced mostly by the family context, such as the woman’s age at the time of her pregnancy and the number of children in the household, the woman’s level of prenatal education and information about postnatal care, as well as some hospital variables such as the characteristics and organization of the maternity units. Full participation in the program was influenced by the accessibility to health professionals, particularly midwives. Furthermore, the women’s level of prenatal education and information about postnatal care, as well as their accessibility to health professionals, correlated with the socioeconomic environment.

Conclusion

While individual factors impacted enrollment in the PRADO program, only healthcare system-related factors influenced full participation in the program. A public health policy promoting home-based postnatal care could increase the women’s participation by improving their level of prenatal education and information about postnatal care. In addition, reducing regional inequality is likely to have a positive impact, as the availability of health professionals is a key factor for participation in home-based postnatal coordinated care.

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Haute Autorité de Santé (HAS). Sortie de maternité après accouchement : conditions et organisation du retour à domicile des mères et de leurs nouveau-nés. Argumentaire. Mars 2014. Available at: https://www.has-sante.fr/upload/docs/application/pdf/2014-03/argumentaire_scientifique_-_sortie_de_maternite_apres_accouchement.pdf. Accessed July 28, 2021.

Cegolon L, Campbell O, Alberico S, Montico M, Mastrangelo G, Monasta L, et al. Length of stay following vaginal deliveries: a population based study in the Friuli Venezia Giulia region (north-eastern Italy), 2005-2015. PLoS One. 2019;14(1):e0204919. https://doi.org/10.1371/journal.pone.0204919.CrossRefPubMedPubMedCentral

Cegolon L, Mastrangelo G, Campbell OM, Giangreco M, Alberico S, Montasta L, et al. Length of stay following cesarean sections: A population based study in the Friuli Venezia Giulia region (North-Eastern Italy), 2005–2015. PLoS One. 2019;14(2):e0210753. https://doi.org/10.1371/journal.pone.0210753.CrossRefPubMedPubMedCentral

Campbell O, Cegolon L, McLeod D, Benova L. Length of stay after childbirth in 92 countries and associated factors in 30 low- and middle- income countries: compilation of reported data and a cross sectional analysis from nationally representative surveys. PLoS Med. 2016;13(3):e1001972. https://doi.org/10.1371/journal.pmed.1001972.CrossRefPubMedPubMedCentral

Bravo P, Uribe C, Contreras A. Early postnatal hospital discharge: the consequences of reducing length of stay for women and newborns. Rev Esc Enferm USP. 2011;45(3):758–63. https://doi.org/10.1590/s0080-62342011000300030.CrossRefPubMed

Kruse AR, Lauszus FF, Forman A, Kesmodel US, Rugaard MB, Knudsen RK, et al. Effect of early discharge after planned cesarean section on recovery and parental sense of security. A randomized clinical trial. Acta Obstet Gynecol Scand. 2021;100(5):955–63. https://doi.org/10.1111/aogs.14041.CrossRefPubMed

Bowers J, Cheyne H. Reducing the length of postnatal hospital stay: implications for cost and quality of care. BMC Health Serv Res. 2016;16(1):16. https://doi.org/10.1186/s12913-015-1214-4.CrossRefPubMedPubMedCentral

World Health Organization (WHO). WHO recommendations on postnatal care of the mother and newborn. Geneva: World Health Organization 2013. Available at: https://apps.who.int/iris/bitstream/handle/10665/97603/?sequence=1. Accessed July 28, 2021.

Chalmers B, Mangiaterra V, Porter R. WHO principles of perinatal care: the essential antenatal, perinatal, and postpartum care course. Birth. 2001;28(3):202–7. https://doi.org/10.1046/j.1523-536x.2001.00202.x.CrossRefPubMed

10.

Sellwood M, Huertas-Ceballo A. Review of NICE guidelines on routine postnatal infant care. Arch Dis Child Fetal Neonatal Ed. 2008;93(1):F10–3. https://doi.org/10.1136/adc.2006.111757.CrossRefPubMed

11.

Lemyre B, Jefferies AL, O'Flaherty P. Facilitating discharge from hospital of the healthy term infant. Paediatr Child Health. 2018;23(8):515–31. https://doi.org/10.1093/pch/pxy127.CrossRefPubMedPubMedCentral

12.

Jones E, Stewart F, Taylor B, Davis PG, Brown SJ. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Rev. 2021;6(6):CD002958. https://doi.org/10.1002/14651858.CD002958.pub2.CrossRefPubMed

13.

Vergier N, Chaput H, Lefebvre-Hoang I (DREES). Déserts médicaux : comment les définir ? Comment les mesurer ? Les Dossiers de la Drees 2017;17. Available at: http://www.epsilon.insee.fr/jspui/bitstream/1/62913/1/dossiers_17.pdf. Accessed July 28, 2021.

14.

Luo W, Qi Y. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health Place. 2009;15(4):1100–7. https://doi.org/10.1016/j.healthplace.2009.06.002.CrossRefPubMed

15.

Puhani, P. The Heckman correction for sample selection and its critique. Journal of economic surveys 2000;14(1):53-68. Available at: https://doi.org/10.1111/1467-6419.00104. Accessed July 28, 2021, 2000.

16.

StataCorp. Stata Statistical Software: Release.USA: College Station, TX: StataCorp LP.

17.

Institut National de la Statistique et des Études Économiques (INSEE). Available at: https://www.insee.fr/fr/accueil.htm. Accessed July 16, 2020.

18.

Gao F, Kihal W, Le Meur N, Souris M, Deguen S. Assessment of the spatial accessibility to health professionals at French census block level. Int J Equity Health. 2016;15(1):125. https://doi.org/10.1186/s12939-016-0411-z.CrossRefPubMedPubMedCentral

19.

Menichetti J, Libreri C, Lozza E, Graffigna G. Giving patients a starring role in their own care: a bibliometric analysis of the on-going literature debate. Health Expect. 2016;19(3):516–26. https://doi.org/10.1111/hex.12299.CrossRefPubMed

20.

Song Y, Skinner J, Bynum J, Sutherland J, Wennberg JE, Fisher ES. Regional variations in diagnostic practices. NEngl J Med. 2010;363(1):45–53. https://doi.org/10.1056/NEJMsa0910881.CrossRef

21.

Kopetsch T, Schmitz H. Regional variation in the utilisation of ambulatory services in Germany. Health Econ. 2014;23(12):1481–92. https://doi.org/10.1002/hec.3001.CrossRefPubMed

22.

Johansson N, Jakobsson N, Svensson M. Regional variation in health care utilization in Sweden - the importance of demand-side factors. BMC Health Serv Res. 2018;18(1):403. https://doi.org/10.1186/s12913-018-3210-y.CrossRefPubMedPubMedCentral

23.

Fryer AK, Friedberg MW, Thompson RW, Singer SJ. Patient perceptions of integrated care and their relationship to utilization of emergency, inpatient and outpatient services. Healthc (Amst). 2017;5(4):183–93. https://doi.org/10.1016/j.hjdsi.2016.12.005.CrossRef

24.

Vogt V, Siegel M, Sundmacher L. Examining regional variation in the use of cancer screening in Germany. SocSci Med. 2014;110:74–80. https://doi.org/10.1016/j.socscimed.2014.03.033.CrossRef

25.

Ozegowski S, Sundmacher L. Understanding the gap between need and utilization in outpatient care--the effect of supply-side determinants on regional inequities. Health Policy. 2014;114(1):54–63. https://doi.org/10.1016/j.healthpol.2013.08.005.CrossRefPubMed

26.

Milcent C, Zbiri S. Prenatal care and socioeconomic status: effect on cesarean delivery. Health Econ Rev. 2018;8(1):7. https://doi.org/10.1186/s13561-018-0190-x.CrossRefPubMedPubMedCentral

27.

Schley K. Health care service provision in Europe and regional diversity: a stochastic metafrontier approach. Health Econ Rev. 2018;8(1):11. https://doi.org/10.1186/s13561-018-0195-5.CrossRefPubMedPubMedCentral

28.

Herwartz H, Schley K. Improving health care service provision by adapting to regional diversity: an efficiency analysis for the case of Germany. Health Policy. 2018;122(3):293–300. https://doi.org/10.1016/j.healthpol.2018.01.004.CrossRefPubMed

29.

Chevreul K, Berg Brigham K, Durand-Zaleski I, Hernandez-Quevedo C. France: Health System Review. Health Syst Transit. 2015;17(3):1-xvii. PMID: 26766545.

30.

De Pietro C, Camenzind P, Sturny I, et al. Switzerland: health system review. Health Syst Transit. 2015;17(4):1-xix. PMID: 26766626.

31.

Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E. Netherlands: health system review. Health Syst Transit 2016;18(2):1–240. PMID: 27467715.

32.

Thomson K, Moffat M, Arisa O, Jesurasa A, Richmond C, Odeniyi A, et al. Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis. BMJ Open. 2021 Mar 15;11(3):e042753. https://doi.org/10.1136/bmjopen-2020-042753.CrossRefPubMedPubMedCentral

33.

Bowers J, Cheyne H, Mould G, Page M. Continuity of care in community midwifery. Health Care ManagSci. 2015;18(2):195–204. https://doi.org/10.1007/s10729-014-9285-z.CrossRef

34.

Assurance Maladie. Convention nationale des sages-femmes et ses avenants. Available at: https://www.ameli.fr/sage-femme/textes-reference/convention. Accessed July 31, 2020.

35.

LOI n° 2012–300 du 5 mars 2012 relative aux recherches impliquant la personne humaine. Available at: https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000025441587/. Accessed June 2, 2021.

Title: Access-to-care: evidence from home-based postnatal coordinated care after hospital discharge
Authors: Saad Zbiri
Patrick Rozenberg
Carine Milcent
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-021-07151-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Access-to-care: evidence from home-based postnatal coordinated care after hospital discharge

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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