B Blondel1, G Breart. 1. INSERM-U 149, Maternal and Child Health Epidemiological, Villejuif, France.
Abstract
OBJECTIVE: To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units. DESIGN: A meta-analysis of three randomized controlled trials. SETTING: 9 maternity units in France. SUBJECTS: 1410 women with pregnancy complications. INTERVENTION: 1 or 2 home visits a week by a midwife. MAIN OUTCOME MEASURES: Admission rate and length of stay in hospital. RESULTS: The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7-1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups. CONCLUSIONS: The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.
OBJECTIVE: To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units. DESIGN: A meta-analysis of three randomized controlled trials. SETTING: 9 maternity units in France. SUBJECTS: 1410 women with pregnancy complications. INTERVENTION: 1 or 2 home visits a week by a midwife. MAIN OUTCOME MEASURES: Admission rate and length of stay in hospital. RESULTS: The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7-1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups. CONCLUSIONS: The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.