Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands

BMC Pregnancy and Childbirth

Research Article

Lidewij Henneman¹  Suze Jans²  Ank de Jonge³  Hilde Perdok⁴  Corine Verhoeven⁵  Therese Wiegers⁶  François Schellevis⁷  Ben Willem Mol⁸ 

[1] Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;TNO Quality of Life, Leiden, The Netherlands;Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Catharina Hospital, Eindhoven, The Netherlands;Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Maxima Medical Centre, Veldhoven, The Netherlands;Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia;

关键词: Continuity of care;    Integrated care;    Maternity care;    Obstetrics;    Midwifery;   

DOI  :  10.1186/s12884-016-0975-z

 received in 2016-02-12, accepted in 2016-07-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThis study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care.MethodsQualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described.ResultsThree main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy.ConclusionsAn integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.

【 授权许可】

CC BY   
© The Author(s). 2016