Maternity models of care in Australia, 2022

About the model of care national best practice data set

The scope of the MoC NBPDS is all models of maternity care available to pregnant and birthing women in Australia. The elements in the data set describe the different characteristics of models of maternity care around 3 domains:

• the women a model is designed for;
• the carers working within the model; and
• how care is commonly provided.

Information about each of the data elements in the MoC NBPDS are in Technical notes and on METEOR.

How is data collected?

The AIHW developed the MaCCS data collection tool (DCT) to collect information on the models of care available at each maternity service. A registered user in each service uses the DCT to classify their models of care, by answering a series of questions on each model of care they offer. This ensures they are classified in a standardised way. The questions used to classify each model of care are in Technical notes.

The DCT has a user guide to help registered users enter their models of care information accurately, and inbuilt validation and tool tips to reduce reporting errors. The AIHW also maintains a helpdesk to support services to classify their models of care. To ensure information is kept up to date, the AIHW asks maternity services to review and update their models of care annually and validates new and updated models when they are submitted. Validation queries are followed up with maternity services. Any models of care with significant data quality queries still attached to them after follow up are excluded from reporting. For this report, 5 active models of care (less than 1%) were excluded from national reporting.

The information submitted to the DCT forms the basis of the MoC NBPDS. Summary information about each model of care submitted to the DCT is available for each maternity service at the MaCCS website. This includes the model ID number, model name and the major model category it falls under. 

Capturing models of care in the National Perinatal Data Collection

Collecting models of care at the service level also facilitates the inclusion of model of care data elements into the NPDC. The two model of care data elements going into the NPDC are primary maternity model of care and maternity model of care at the onset of labour or non-labour caesarean section. The model of care at the onset of labour or non-labour caesarean section may be similar to, or different from, the primary model of care a woman received through her pregnancy. The MaCCS DCT allocates a unique model ID number to each model of care entered to it. Model ID numbers can then be used to populate the two model of care data elements in each woman’s perinatal data record and to link NPDC data with other information in the MoC NBPDS. Analyses based on the number of women that receive a particular model of care will be possible once these model of care data elements are routinely collected in the NPDC.

A note about coverage

In 2022, most (93%) maternity services with birth facilities had at least 1 ac​tive, or in use model of care, classified in the MaCCS DCT, an increase from 90% of services in 2021 (see Table 1). However, a national baseline for ALL maternity models of care is not yet available because:

• Classifying models of care for the MoC NBPDS is voluntary
• While coverage rates are 85% or above in all jurisdictions, they still vary by jurisdiction and type of service
• In services that have submitted models of care to the DCT it is possible that not all available models of care have been entered
• There is a gap in the collection of models of care with a major model category of private midwifery care. This is because the AIHW has engaged primarily with maternity services and not private midwives directly. While the number of models in this category is likely to be small and some hospitals have entered models on behalf of private midwives, this category still has poorer coverage compared to other major model categories. Strategies are being developed to engage more with private midwives and to collect their models of care in future collections.

Notes

1. Includes maternity services with birth facilities.
2. Active models are those that have been classified and submitted to the MaCCS DCT and are in use at a maternity service, at 30 April 2022.

Source: MaCCS DCT, 2022.

How can we improve the collection?

The completeness and quality of the MoC NBPDS will continue to improve as familiarity with the MaCCS DCT grows, with further engagement by maternity services and maternity service providers and with the inclusion of the two model of care data elements into the NPDC. The AIHW will continue its work to improve the accuracy and completeness of the models of care information and to incorporate these data elements into other maternal and perinatal health reporting.