Economic Evaluation of Specialised Antenatal Care: The Case of Rainbow Clinics
What are we trying to do?
We are conducting an economic evaluation of the Rainbow Clinic model, which provides specialised antenatal care for pregnant women following a previous perinatal death (including stillbirth, neonatal death or termination of pregnancy for medical reasons). The study will assess clinical outcomes, healthcare resource use, and cost-effectiveness of Rainbow Clinics compared to standard antenatal care within the NHS.
Why is this important?
Pregnancy after stillbirth or neonatal death carries heightened clinical risks and significant psychological distress. Although Rainbow Clinics offer personalised, multidisciplinary support, there is limited evidence on their financial sustainability. This evaluation will provide vital insights into whether the improved outcomes justify the resource investment, helping inform national policy and funding decisions.
How are we doing it?
Using a retrospective cohort design, we are analysing individual-level clinical data from Rainbow Clinics across 21 NHS Trusts and comparing it with matched data from women receiving standard care (women who met the criteria for Rainbow Clinic but were not seen there).
This study is linking anonymised data from the Rainbow Clinic registry with national NHS health databases (HES/MSDS) to get a full picture of care and outcomes.
The study employs advanced methods including:
- matching methods (such as propensity score matching)
- multivariable regression
- a staggered Difference-in-Differences framework.
Outcomes include:
- antenatal visits
- NICU admissions
- stillbirths
- cost per outcome avoided through cost-consequence analysis.
Who are we working with?
This study is being conducted in collaboration with 21 NHS Trusts across England and Wales.
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Funding information
More information
Senior Programme Lead
Mike Spence
michael.spence@manchester.ac.uk