Client-centered flexible planning of home-based postpartum care: A randomized controlled trial on the quality of care.
Publication year
2024Source
Birth : Issues in Perinatal Care, 51, 3, (2024), pp. 649-658ISSN
Annotation
01 september 2024
Publication type
Article / Letter to editor
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Organization
Gynaecology
IQ health
Journal title
Birth : Issues in Perinatal Care
Volume
vol. 51
Issue
iss. 3
Page start
p. 649
Page end
p. 658
Subject
Gynaecology - Radboud University Medical Center; IQ health - Radboud University Medical CenterAbstract
BACKGROUND: Standardization of health systems often hinders client-centered care. This study investigates whether allowing more flexibility in the planning range of the Dutch home-based postpartum care service improves its quality of care, as innovative approach to client-centered care. METHODS: A randomized controlled trial was conducted (2017-2019), in which pregnant women who intended to breastfeed were assigned into two groups (1:1). The intervention group was allowed to receive care up to the 14th-day postpartum, instead of the first 8-10 consecutive days ("usual care"). Primary outcome measure was the proportion of newborns still receiving exclusively breastmilk on final caring day of the service. This so-called successful breastfeeding rate is currently used by the Dutch health sector to measure the quality of care. Secondary outcome measures were self-care experience, overall care experience, and exclusive breastfeeding duration rate. RESULTS: Based on data from 1275 participants, there was no difference in exclusive breastfeeding on final caring day (86,7% intervention group vs. 88,9% control group, RR: 1.03, 95% CI: 0.98-1.07). Both groups showed similar self-care experiences. Women in the intervention group had slightly poorer overall care experience and lower exclusive breastfeeding duration rates. CONCLUSIONS: This study found no effect on the quality of care when allowing more flexibility in the planning range of home-based postpartum care. Women can, therefore, be offered more flexibility to suit them. Given the confusion in interpreting the sector's current main quality indicator, we call for an inclusive dialogue on how to best measure the quality of home-based postpartum care.
This item appears in the following Collection(s)
- Academic publications [246423]
- Electronic publications [134024]
- Faculty of Medical Sciences [93307]
- Open Access publications [107543]
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