Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals

Mi-Ran Park; Ju-Young Lee

doi:10.4069/kjwhn.2018.24.1.24

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Park and Lee: Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals

Orginal Article

Korean J Women Health Nurs 2018;24(1):24-32.

Published online: 20 March 2018

DOI: https://doi.org/10.4069/kjwhn.2018.24.1.24

Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals

Mi-Ran Park, Ju-Young Lee

College of Nursing, The Catholic University of Korea, Seoul, Korea

Corresponding author: Lee, Ju-Young College of Nursing, The Catholic University, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel: +82-2-2258-7808, Fax: +82-2-2258-7772, E-mail: jylee83@catholic.ac.kr

Received 12 October 201724 November 2017 Accepted 21 December 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals.

Methods

This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic.

Results

Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals.

Conclusion

Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

References

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Table 1.

General and Pregnancy and Delivery related Characteristics of Participants (N=140)

			Midwifery clinic	Hospital
Variables	Characteristics	Categories	delivery (n=70)	delivery (n=70)	x² or t	p
			n (%) or M±SD	n (%) or M±SD
General	Age (year)	＜35	49 (70.0)	48 (68.6)	–0.03	.855
characteristics		≥35	21 (30.0)	22 (31.4)
			33.7±5.2	32.7±4.2	–0.53	.599
	Spouse's age (year)		34.6±5.4	35.2±4.6	–0.23	.820
	Educational level^†	≤High school	5 (7.2)	6 (8.6)	0.08	.772
		≥College	64 (92.8)	64 (91.4)
	Job	Yes	42 (60.0)	45 (64.3)	0.27	.601
		No	28 (40.0)	25 (35.7)
	Cohabitants	Yes	9 (12.9)	12 (17.1)	0.50	.478
	(except spouse)	No	61 (87.1)	58 (82.9)
	Average monthly income	(10,000 won)	424.9±205.9	642.3±810.1	2.28	.024
Pregnancy and	Times of prenatal care		9.1±4.0	13.3±5.1	5.49	＜.001
delivery related characteristics	Maternal childbirth education participation	Yes No	60 (85.7) 10 (14.3)	19 (27.1) 51 (72.9)	48.84	＜.001
	Spouse's childbirth	Yes	57 (81.4)	18 (25.7)	43.68	＜.001
	education participation	No	13 (18.6)	52 (74.3)
	Satisfaction with	Satisfactory	60 (85.7)	56 (80.0)	0.88^‡	.663
	support during	Average	8 (11.4)	11 (15.7)
	pregnancy	Unsatisfactory	2 (2.9)	3 (4.3)
	Gestational age (week)	＜40	31 (44.3)	39 (55.7)	1.83	.176
		≥40	39 (55.7)	31 (44.3)
	Para	Primi	34 (48.6)	34 (48.6)	0.00	1.000
		Multi	36 (51.4)	36 (51.4)
	Birth weight of baby (kg)		3.4±0.4	3.2±0.4	–1.37	.173
	Gender of baby	Female	25 (35.7)	44 (62.9)	10.32	＜.001
		Male	45 (64.3)	26 (37.1)
	Birth-related health problem^§\|\|	Yes No	20 (28.6) 50 (71.4)	26 (37.1) 44 (62.9)	1.17	.280
	Birth-related health problem of baby^§¶	Yes No	3 (4.3) 67 (95.7)	20 (28.6) 50 (71.4)	15.04	＜.001
	1-minute Apgar score		8.7±0.6	8.3±0.8	–2.80	.006
	5-minute Apgar score		9.7±0.5	9.3±0.8	–3.27	.002
	First stage of labor (hour)		10.9±5.9	10.3±9.7	–0.06	.953
	Duration of labor a	Longer	22 (31.4)	13 (18.6)	3.11	.211
	puerperal felt	Similar	22 (31.4)	27 (38.6)
		Shorter	26 (37.1)	30 (42.9)
Length of stay (day	y)		1.4±0.6	3.2±0.6	16.61	＜.001
			(1∼3)	(2∼5)
Health care cost (10	0,000 won)		58.6±13.0	96.6±48.0	4.67	＜.001
			(40.0∼100.0)	(13.7∼205.7)

^† Missing value

^‡ Fisher's exact test;

^§ Multiple response;

^|| Perineal laceration, vaginal bleeding, dysuresia, constipation etc;

^¶ Meconium stain, trauma, infection etc.

Table 2.

Postpartum Discomfort (N=140)

Areas	Possible item range	Midwifery clinic delivery (n=70)		Hospital delivery (n=70)		t	p
Areas	Possible item range	M±SD	Min∼Max	M±SD	Min∼Max	t	p
Physical	1∼5	1.9±0.5	1.0∼3.2	2.6±0.7	1.6∼4.6	6.93	＜.001
Emotional	1∼5	1.7±0.5	1.0∼3.3	2.2±0.6	1.1∼3.8	4.92	＜.001
Environmental	1∼5	1.3±0.4	1.0∼1.3	2.0±0.6	1.0∼3.1	8.44	＜.001
Social·Cultural	1∼5	1.7±0.7	1.0∼1.8	2.3±0.6	1.0∼4.2	5.54	＜.001

Table 3.

Satisfaction with the Medical Service (N=140

Variables	Possible item range M	Midwifery clinic delivery (n=70)	Hospital delivery (n=70)	t	p
Variables	Possible item range M	M±SD	M±SD	t	p
Perception of medical service	1∼5	4.7±0.3	4.1±0.5	–8.04	＜.001
Satisfaction of medical service	1∼5	4.8±0.4	4.2±0.6	–6.82	＜.001

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