Choice of public versus private hospital for maternity care: a cross-sectional questionnaire study Abstract

So-Ling LAU, Jessica Yun-Pu LAW, Kwok-Keung TANG
Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
Objective: To determine factors influencing the choice of public versus private hospital for maternity care and the satisfaction level of women on obstetric service.
Methods: Women who attended their first antenatal visit between 1 March 2018 and 30 April 2018 at the Pamela Youde Nethersole Eastern Hospital were contacted via telephone at 6 to 12 weeks after delivery to complete a questionnaire about (1) details of delivery, (2) factors affecting choice of hospital for maternal care, and (3) satisfaction towards obstetric services, whether to return to the same hospital for next delivery, and breastfeeding practices.
Results: 409 (89.1%) of 459 women completed the questionnaire. Of the 409 respondents, 308 (75.1%) delivered in our public hospital and 101 (24.6%) delivered in private hospitals. Those who chose to deliver in the private hospitals were more likely to be older (34.07 vs 32.56, p=0.007), primiparous (69.3% vs 52.3%, p=0.003), and have tertiary or higher education level (85.1% vs 54.9%, p<0.001). In the public hospital group, more women had normal vaginal delivery (57.5% vs 19.8%, p<0.001) and fewer women had Caesarean section (32.8% vs 77.2%, p<0.001). The private hospital group had higher rating for antenatal service, with more women rated ≥4 (94.1% vs 81.8%, p=0.024). More women in the public hospital group than in the private hospital group would return for next delivery (93.8% vs 86.1%, p=0.014) and practiced full or partial breastfeeding (91.6% vs 73.3%, p<0.001).
Conclusion: The overall rating to both public and private obstetric services in Hong Kong is good. 24.6% of women chose delivery at private hospitals for reasons such as having designated doctor-in-charge, choice on mode of delivery, and safety issue. The Caesarean section rate was higher in women who chose delivery at private hospitals. Further studies are warranted to investigate the reasons why these women prefer Caesarean delivery.
Hong Kong J Gynaecol Obstet Midwifery 2020; 20(2):62–8
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