Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/27705
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dc.contributor.authorBowers, Johnen_UK
dc.contributor.authorCheyne, Helenen_UK
dc.contributor.authorMould, Gillianen_UK
dc.contributor.authorMiller, Martinen_UK
dc.contributor.authorPage, Mirandaen_UK
dc.contributor.authorHarris, Fionaen_UK
dc.contributor.authorBick, Debraen_UK
dc.date.accessioned2018-09-05T00:00:25Z-
dc.date.available2018-09-05T00:00:25Z-
dc.date.issued2018-12-31en_UK
dc.identifier.other656en_UK
dc.identifier.urihttp://hdl.handle.net/1893/27705-
dc.description.abstractBackground Many healthcare services are under considerable pressure to reduce costs while improving quality. This is particularly true in the United Kingdom’s National Health Service where postnatal care is sometimes viewed as having a low priority. There is much debate about the service’s redesign and the reallocation of resources, both along care pathways and between groups of mothers and babies with different needs. The aim of this study was to develop a decision support tool that would encourage a systemic approach to service redesign and that could assess the various quality and financial implications of service change options making the consequent trade-offs explicit. The paper describes the development process and an initial implementation as a preliminary exploration of the possible merits of this approach. Methods Other studies have suggested that combining multicriteria decision analysis with programme budgeting and marginal analysis might offer a suitable basis for resource allocation decisions in healthcare systems. The Postnatal care Resource Allocation Model incorporated this approach in a decision support tool to analyse the consequences of varying design parameters, notably staff contacts and time, on the various quality domains and costs. The initial phase of the study focussed on mapping postnatal care, involving interviews and workshops with a variety of stakeholders. This was supplemented with a literature review and the resultant knowledge base was encoded in the decision support tool. The model was then tested with various stakeholders before being used in an NHS Trust in England. Results The model provides practical support, helping staff explore options and articulate their proposals for the redesign of postnatal care. The integration of cost and quality domains facilitates trade-offs, allowing staff to explore the benefits of reallocating resources between hospital and community-based care, and different patient-categories. Conclusions The main benefits of the model include its structure for assembling the key data, sharing evidence amongst multi-professional teams and encouraging constructive, systemic debate. Although the model was developed in the context of the routine maternity services for mothers and babies in the days following birth it could be adapted for use in other health care services.en_UK
dc.language.isoenen_UK
dc.publisherSpringer Nature America, Incen_UK
dc.relationBowers J, Cheyne H, Mould G, Miller M, Page M, Harris F & Bick D (2018) A multicriteria resource allocation model for the redesign of services following birth. BMC Health Services Research, 18 (1), Art. No.: 656. https://doi.org/10.1186/s12913-018-3430-1en_UK
dc.rights© The Author(s). 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectPostnatal careen_UK
dc.subjectMaternity servicesen_UK
dc.subjectCost savingsen_UK
dc.subjectCare qualityen_UK
dc.subjectResource allocationen_UK
dc.subjectPriority settingen_UK
dc.subjectProgram budgeting and marginal analysisen_UK
dc.subjectMulticriteria decision analysisen_UK
dc.titleA multicriteria resource allocation model for the redesign of services following birthen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/s12913-018-3430-1en_UK
dc.identifier.pmid30134882en_UK
dc.citation.jtitleBMC Health Services Researchen_UK
dc.citation.issn1472-6963en_UK
dc.citation.volume18en_UK
dc.citation.issue1en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderScottish Government Chief Nurse’s Officeen_UK
dc.contributor.funderEconomic and Social Research Councilen_UK
dc.contributor.funderRoyal College of Midwivesen_UK
dc.citation.date22/08/2018en_UK
dc.contributor.affiliationManagement, Work and Organisationen_UK
dc.contributor.affiliationNMAHPen_UK
dc.contributor.affiliationManagement, Work and Organisationen_UK
dc.contributor.affiliationNMAHPen_UK
dc.contributor.affiliationNMAHPen_UK
dc.contributor.affiliationKing's College Londonen_UK
dc.identifier.isiWOS:000442486700008en_UK
dc.identifier.scopusid2-s2.0-85051939853en_UK
dc.identifier.wtid985152en_UK
dc.contributor.orcid0000-0001-5738-8390en_UK
dc.contributor.orcid0000-0003-3258-5624en_UK
dc.date.accepted2018-07-30en_UK
dcterms.dateAccepted2018-07-30en_UK
dc.date.filedepositdate2018-09-04en_UK
rioxxterms.apcpaiden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorBowers, John|en_UK
local.rioxx.authorCheyne, Helen|0000-0001-5738-8390en_UK
local.rioxx.authorMould, Gillian|en_UK
local.rioxx.authorMiller, Martin|en_UK
local.rioxx.authorPage, Miranda|en_UK
local.rioxx.authorHarris, Fiona|0000-0003-3258-5624en_UK
local.rioxx.authorBick, Debra|en_UK
local.rioxx.projectProject ID unknown|Scottish Government Chief Nurse’s Office|en_UK
local.rioxx.projectKTP008934|Economic and Social Research Council|http://dx.doi.org/10.13039/501100000269en_UK
local.rioxx.projectProject ID unknown|Royal College of Midwives|http://dx.doi.org/10.13039/100008892en_UK
local.rioxx.freetoreaddate2018-09-04en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2018-09-04|en_UK
local.rioxx.filenames12913-018-3430-1.pdfen_UK
local.rioxx.filecount1en_UK
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