Shared Antenatal Care between Family Health Services and Hospital (Consultant) Services for Low Risk Women

Four thousand four hundred and seventy-two patients were recruited into a project to test the efficacy of a Shared Care System in the management of low risk antenatal patients. The patients were scored according to a simple point scoring system. Three thousand three hundred and fourty-seven (74.8%) were scored as low risk. Fifty point two percent (1,682) of these low risk patients received the conventional system of care and acted as controls; while 49.8% (1,665) received shared care, where they were seen jointly by midwives, general doctors and hospital specialists. It was found that with the use of shared care, there was a significant decrease in workload to the hospital specialty clinics. Not only was the antenatal diagnostic rate of intrauterine growth retardation (IUGR) significantly improved, but the mean gestations at which IUGR, malpresentations, and pregnancy induced hypertension were diagnosed were also significantly earlier. The number of antenatal cardiotocographs performed, as well as the number of hospital admissions and mean duration of stay were decreased in the study group. The overall cost savings to the hospital was calculated if the shared care system was generally adopted.