Does general practitioner involvement in commissioning maternity care make a difference?

Wyke, S. , Hewison, J., Elton, R., Posnett, J., MacLeod, L. and Ross-McGill, H. (2001) Does general practitioner involvement in commissioning maternity care make a difference? Journal of Health Services Research and Policy, 6(2), pp. 99-104.

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Objectives: To evaluate the impact of general practitioners' commissioning of maternity services on women's experiences of care and on resource use, and to consider the implications for primary care commissioning. Method: Comparison of women's experiences and resource use between 11 commissioning and 10 non-commissioning general practices. Face-to-face interviews with 212 staff in general practices, National Health Service trusts and health authorities between 1996 and 1998 to establish how maternity care was organised. Women's experience of information, choice, control and resource use obtained by questionnaire mailed 4 weeks post-partum. Data were analysed using multi-level modelling to adjust for case-mix differences. Results: After two reminders, 1957 women (62%) responded to the questionnaire (inter-practice range 52-81%). There were no significant differences in women's experience of care or their resource use between commissioning and non-commissioning practices. Commissioning practices were more likely to be associated with more vertically integrated models of service organisation, but responses to only three of 21 questions about experience of information, choice and control over care, or about resource use, differed between the four models of service organisation identified. Conclusions: The expectation that giving primary care organisations responsibility for commissioning care will result in improved patients' experiences of care or better use of resources should be treated with caution. The presence of strong national policy may be equally important. Models of service organisation are not proxies for quality of care. The most powerful force shaping patients' experiences of care may be health care professionals' ability to translate national policy into local services

Item Type:Articles
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally
Authors: Wyke, S., Hewison, J., Elton, R., Posnett, J., MacLeod, L., and Ross-McGill, H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences
Journal Name:Journal of Health Services Research and Policy
Publisher:Royal Society of Medicine Press Ltd.
ISSN (Online):1758-1060

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