Objective: To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units.
Design: A meta-analysis of three randomized controlled trials.
Setting: 9 maternity units in France.
Subjects: 1410 women with pregnancy complications.
Intervention: 1 or 2 home visits a week by a midwife.
Main outcome measures: Admission rate and length of stay in hospital.
Results: The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7-1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups.
Conclusions: The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.