112 Chapter 5 Actual and reimbursed costs Actual costs for healthcare professionals of an MLCaCTG and an OLC-aCTG summed to €279 and €235, respectively (table 2). According to the Dutch Healthcare Authority, MLC-aCTG reimbursement in 2020 is €280. Due to the percentage of women referred to OLC after a non-reassuring MLC-aCTG, the weighted reimbursement for MLC-aCTG (weighted by the probability of having a reassuring or non-reassuring and subsequently referral) aCTG is €438 (table 2, online supplemental material 1, worksheet ‘care pathways costs’). According to the Vektis data, the mean OLC-aCTG reimbursement was €1492 (SD=€1723), and the median OLC-aCTG reimbursement was €730. Table 1: Parameters used in the budget impact model Parameters Value Reference Epidemiological data Prevalence of performing a reassuring aCTG 87.0% (11) Prevalence of performing a non-reassuring aCTG 13.0% (11) Prevalence of performing an aCTG for three indications 19.8% Online supplementary material 1 Prevalence of performing an aCTG for one indication 14.8% Online supplementary material 1 Number of midwives 138 Online supplementary material 1 Number of aCTG equipment 34 Online supplementary material 1 Number of aCTGs performed per year 1130 Online supplementary material 1 Number of pregnant women in midwife-led care 1816 Online supplementary material 1 Number of healthy pregnant women per year in the Netherlands 144427 (28) Resource use Total hours spent on performing a reassuring MLC-aCTG by a midwife 2.10 Online supplementary material 1 Total hours spent on performing a non-reassuring MLC-aCTG by a midwife 1.80 Online supplementary material 1 Total hours spent on performing an OLC-aCTG by an obstetrician 0.02 Online supplementary material 1 Total hours spent on performing an OLC-aCTG by a medical resident 0.05 Online supplementary material 1 Total hours spent on performing an OLC-aCTG by an obstetrician nurse 0.15 Online supplementary material 1 Total hours spent on preparing an OLC-aCTG by a clinical midwife 0.41 Online supplementary material 1
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