A Cost-Effectiveness Analysis of Prenatal Care Delivery

This cost-effectiveness analysis (CEA) was conducted to evaluate the relative efficiency of three alternative prenatal care programs in rural, low-income areas of Texas. The study compared both the actual cost per visit and the predicted capacity cost per visit, the latter determining which model type has potential to be most efficient. The same clinic modelproved to have the lowest cost per visit when using both actual and adjusted capacity data. After considering specific criteria, cost per visit differences were attributed primarily to the mix of medical personnel. Specifically, the use of certified nurse midwives in conjunction with physician backup proved more costeffective than salaried MDs. Relative efficiency is quantified and reasons for cost differences are identified.