Bron M S, Salmon J W
College of Pharmacy, University of Illinois at Chicago 60612, USA.
Am J Manag Care. 1998 May;4(5):715-20.
The birth of the McCaughey septuplets in Iowa in November 1997 brought issues of fertility assistance and their potential outcomes to worldwide attention. This Pergonal-stimulated multiple pregnancy ended successfully, but not without health hurdles and economic consequences for the new siblings and their family. This article reviews the general situation surrounding infertility services and, within the current debate of epidemiological, economic, legal and social issues, posits that managed care may be able to make greater strides than the present fee-for-service system in providing more accessible and comprehensive care to the 5.3 million US citizens at risk for infertility. Our conclusions suggest that managed care plans for infertility can aid in assuring quality and decreasing unnecessary costs. Managed care organizations should take the lead in providing infertile couples with an organized, humanistic approach that is mindful of the attending social issues. On May 5, 1997, a US District court in Chicago ruled that infertility fits the definition of a disability, and thus is subject to the antidiscrimination enforcement under the Americans with Disabilities Act.
1997年11月，爱荷华州的麦考伊七胞胎诞生，这使得生育辅助问题及其潜在后果引起了全球关注。这次由 Pergonal 刺激引发的多胞胎妊娠最终成功结束，但新出生的兄弟姐妹及其家庭并非没有面临健康障碍和经济后果。本文回顾了不孕不育服务的总体情况，并在当前关于流行病学、经济、法律和社会问题的辩论中指出，与现行的按服务收费系统相比，管理式医疗在为530万面临不孕风险的美国公民提供更易获得且全面的医疗服务方面，可能会取得更大进展。我们的结论表明，不孕不育的管理式医疗计划有助于确保医疗质量并降低不必要的成本。管理式医疗组织应率先为不孕夫妇提供一种有组织、有人文关怀且兼顾相关社会问题的方法。1997年5月5日，芝加哥的一家美国地方法院裁定，不孕符合残疾的定义，因此受《美国残疾人法案》的反歧视执法管辖。
