A COST-EFFECTIVENESS ANALYSIS OF 3 STAFFING MODELS FOR THE DELIVERY OF LOW-RISK PRENATAL-CARE

Background. Health care costs are increasing at more than twice the ra te of inflation, thus, public officials are seeking safe and economic methods to deliver quality prenatal care to poor pregnant women. This study was undertaken to determine the relationship between the cost an d effectiveness of three prenatal clinic staffing models: physician ba sed, mixed staffing, and clinical nurse specialist with physicians ava ilable for consulation. Methods. Maternal and neonatal physiological o utcome data were obtained from the hospital clinical records of 156 wo men attending these clinics. The women were then interviewed concernin g their satisfaction with their prenatal care clinic. The financial of ficer from each clinic provided data on the clinic staffing costs and hours of service. Results. There were no differences in outcomes for t he maternal-neonatal physiological variables, although newborn admissi on to the Neonatal Intensive Care Unit (NICU) approached significance among the clinics. The clinic staffed by clinical nurse specialists ha d the greatest client satisfaction and the lowest cost per visit. Conc lusions. The use of clinical nurse specialists might substantially red uce the cost of providing prenatal care while maintaining quality, and might thereby save valuable resources.