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The Ontario Midwifery Program. Program Evaluation Proposal. Summer 2002. OMP Program Overview What the Literature Shows Description of Evaluation Proposal Questions (and a Few Answers). Agenda. OMP Program Overview. Overview. Literature. Proposed Evaluation. Questions. History.

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Presentation Transcript
slide1

The Ontario Midwifery Program

Program Evaluation Proposal

Summer 2002

slide2
OMP Program Overview
  • What the Literature Shows
  • Description of Evaluation Proposal
  • Questions (and a Few Answers)

Agenda

omp program overview
OMP Program Overview

Overview

Literature

Proposed Evaluation

Questions

history
History

Overview

  • Midwifery became regulated in Ontario in 1994
    • Midwifery care existed previously but wasn’t covered by OHIP
  • The Ontario Midwifery Program was formed as a result
  • Other provinces followed suit by regulating midwifery services

Literature

Proposed Evaluation

Questions

midwifery service components
Midwifery Service Components

Overview

  • Midwifery Education
  • Midwifery Practice
  • Midwifery Research
    • The current study is limited in scope to midwifery practice only

Literature

Proposed Evaluation

Questions

program components
Program Components

Overview

  • Education/Prevention
  • Pre-natal care
  • Labour/Birth care
  • Post-partum care
  • Counseling/Support

Literature

Proposed Evaluation

Questions

slide7

Overview

Literature

Proposed Evaluation

Questions

what the literature shows
What the Literature Shows

Overview

Literature

Proposed Evaluation

Questions

in general
In General

Overview

  • No studies found evaluating funding formula/method/process
  • Some cost-effectiveness studies
    • Focused more on outcomes however
    • Showed some improved outcomes for midwifery over obstetrics

Literature

Proposed Evaluation

Questions

quebec pilot
Quebec Pilot

Overview

  • Multi-faceted evaluation
  • “Set up for failure”, but also for success
  • Lots of opposition to midwifery services in Quebec
    • Midwifery regulation was adopted in the end however
  • Outcome measures showed positive improvements over obstetric care

Literature

Proposed Evaluation

Questions

description of evaluation proposal
Description of Evaluation Proposal

Overview

Literature

Proposed Evaluation

Questions

two parts
Two Parts

Overview

  • Process Evaluation:
    • Funding methods and effectiveness
  • Outcome Evaluation:
    • Economic cost-effectiveness analysis

Literature

Proposed Evaluation

Questions

design
Design

Overview

  • Comparative data analysis approach
  • Economic cost-effectiveness analysis will also be used
  • The sample population consists of low-risk pregnant women receiving maternity care in 2000, 2001, and 2002 in Ontario, Canada

Literature

Proposed Evaluation

Questions

outcome measures
Outcome Measures

Overview

  • Number of prenatal visits per client
  • Epidural use during labour
  • Use of delivery aid devices
  • Caesarean section required
  • Episiotomy required
  • Resuscitation required
  • Length of hospital stay

Literature

Proposed Evaluation

Questions

limitations
Limitations

Overview

  • The client viewpoint is used rather than the preferred societal viewpoint.
  • The use of TPAs is a recent addition to the OMP and therefore data availability may be limited.
  • A cost-effectiveness analysis doesn’t give as complete a picture.
  • Comparing obstetric care data to midwifery care data may be inherently difficult.

Literature

Proposed Evaluation

Questions

questions
Questions?

Overview

Literature

Proposed Evaluation

Questions