Impact of private health insurance incentives on obstetric outcomes in NSW hospitals

The purpose of this study is to analyse the impact of changes in Australian private health insurance coverage as seen inNSW public and private hospital birth profiles, and identify trends in obstetric outcomes from 1997-2001. NSWMidwives Data Collection unit record data is analysed for women who gave birth to a live singleton baby of termgestation (=37weeks) and cephalic presentation in NSW hospitals during 1997 - 2001. Use of private hospitals forchildbirth has increased in conjunction with increases in private health insurance coverage. Although some obstetricinterventions have increased for both public and private hospitals over time, clinical factors do not explain the largedifferences in birth interventions and outcomes between NSW public and private hospitals. Incentives to increaseprivate health insurance coverage appear to be having a negative impact on childbirth, in terms of higher birthintervention and operative birth rates in NSW private hospitals.