Background
The introduction of bundled payment for maternity care, aimed at improving the quality of
maternity care, may affect pregnant women’s choice in providers of maternity care. This
paper describes a Dutch study which examined pregnant women’s preferences when
choosing a maternity care provider. The study focused on factors that enhance the quality of
maternity care versus (restricted) provider choice.
Methods
A discrete choice experiment was conducted amongst 611 pregnant women living in the
Netherlands using an online questionnaire. The data were analysed with Latent Class Analyses. The outcome measure consisted of stated preferences in the discrete choice experiment. Included factors were: information exchange by care providers through electronic
medical records, information provided by midwife, information provided by friends, freedom
to choose maternity care provider and travel distance.
Results
Four different preference structures were found. In two of those structures, respondents
found aspects of the maternity care related to quality of care more important than being able
to choose a provider (provider choice). In the two other preference structures, respondents
found provider choice more important than aspects related to quality of maternity care.
Conclusions
In a country with presumed high-quality maternity care like the Netherlands, about half of
pregnant women prefer being able to choose their maternity care provider over organisational factors that might imply better quality of care. A comparable amount of women find quality-related aspects most important when choosing a maternity care provider and are
willing to accept limitations in their choice of provider. These insights are relevant for policy
makers in order to be able to design a bundled payment model which justify the preferences
of all pregnant women