Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal.

Journal: BMC health services research

Volume: 18

Issue: 1

Year of Publication: 2019

Affiliated Institutions:  University of California, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA. International Consortium for Health Outcomes Measurement, Cambridge, MA, USA. Karolinska Institutet, Stockholm, Sweden. Erasmus Medical Center, Rotterdam, Netherlands. Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA. University Hospital Southampton, Hampshire, UK. National Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia. Balliol College, University of Oxford, Oxford, UK. Kaiser Permanente, Richmond, CA, USA. Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa. Massachusetts General Hospital, Boston, MA, USA. University Medical Center Utrecht, Utrecht, Netherlands. Sultanah Aminah Hospital, Johor Ministry of Health, Johor Bahru, Malaysia. South Australian Maternity Reform Association (SAMRA) Inc, Adelaide, Australia. California Maternal Quality Care Collaborative, Stanford, CA, USA. University of Mississippi Medical Center, Jackson, MS, USA. Women and Children's Health Network, North Adelaide, South Australia. National Partnership for Women & Families, Washington, D.C., USA. American College of Nurse Midwives, Silver Spring, MD, USA. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA. International Consortium for Health Outcomes Measurement, Cambridge, MA, USA. A.Franx-@umcutrecht.nl.

Abstract summary 

Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set.The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined.We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care.

Authors & Co-authors:  Nijagal Malini Anand MA Wissig Stephanie S Stowell Caleb C Olson Elizabeth E Amer-Wahlin Isis I Bonsel Gouke G Brooks Allyson A Coleman Matthew M Devi Karalasingam Shamala S Duffy James M N JMN Flanagan Tracy T Gebhardt Stefan S Greene Meridith E ME Groenendaal Floris F R Jeganathan J Ravichandran JR Kowaliw Tessa T Lamain-de-Ruiter Marije M Main Elliott E Owens Michelle M Petersen Rod R Reiss Irwin I Sakala Carol C Speciale Anna Maria AM Thompson Rachel R Okunade Oluwakemi O Franx Arie A

Study Outcome 

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Statistics
Citations :  Nippita TA, Trevena JA, Patterson JA, Ford JB, Morris JM, Roberts CL. Variation in hospital rates of induction of labour : a population-based record linkage study. BMJ Open. 2015;5(e008755):1–8.
Authors :  26
Identifiers
Doi : 953
SSN : 1472-6963
Study Population
Women
Mesh Terms
Consensus
Other Terms
Consensus;DELPHI process;Delivery outcomes;Health outcomes;Obstetrics;Outcome measures;Patient-centred outcomes;Patient-reported;Perinatal health;Pregnancy
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England