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A validation study of the Australian Maternity Care Classification System


Donnolley, NR and Chambers, GM and Butler-Henderson, KA and Chapman, MG and Sullivan, E, A validation study of the Australian Maternity Care Classification System, Women and Birth, 32, (3) pp. 204-212. ISSN 1871-5192 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 Australian College of Midwives

DOI: doi:10.1016/j.wombi.2018.08.161


Background: The Maternity Care Classification System is a novel system developed in Australia to classify models of maternity care based on their characteristics. It will enable large-scale evaluations of maternal and perinatal outcomes under different models of care independently of the model’s name.

Aim: To assess the accuracy, repeatability and reproducibility of the Maternity Care Classification System.

Method: All 70 public maternity services in New South Wales, Australia, were invited to classify three randomly allocated model case-studies using a web-based survey tool and repeat their classifications 4–6 weeks later. Accuracy of classifications was assessed against the correct values for the case-studies; repeatability (intra-rater reliability) was analysed by percent agreement and McNemar’s test between the same participants in both surveys; and reproducibility (inter-rater reliability) was assessed by percent agreement amongst raters of the same case-study combined with Krippendorff’s alpha coefficient for a subset of characteristics.

Results: The accuracy of the Maternity Care Classification System was high with 90.8% of responses correctly classified; was repeatable, with no statistically significant change in the responses between the two survey instances (mean agreement 91.5%, p > 0.05 for all but one variable); and was reproducible with a mean percent agreement across 9 characteristics of 83.6% and moderate to substantial agreement as assessed by a Krippendorff’s alpha coefficient of 0.4–0.8.

Conclusion: The results indicate the Maternity Care Classification System is a valid system for classifying models of care in Australia, and will enable the legitimate evaluation of outcomes by different models of care.

Item Details

Item Type:Refereed Article
Keywords:MaCCs, maternity, classification
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health care administration
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Butler-Henderson, KA (Associate Professor Kerryn Butler-Henderson)
ID Code:128182
Year Published:2018
Web of Science® Times Cited:6
Deposited By:TSBE
Deposited On:2018-09-06
Last Modified:2022-07-05

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