Howell Embry, Palmer Ashley, Benatar Sarah, Garrett Bowen
The Urban Institute-Health Policy Center.
Medicare Medicaid Res Rev. 2014 Sep 9;4(3). doi: 10.5600/mmrr.004.03.a06. eCollection 2014.
Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women.
The study uses results from a study of maternal and infant outcomes at the Family Health and Birth Center in Washington, D.C. Costs to Medicaid are derived from birth center data and from other national sources of the cost of obstetrical care.
We estimate that birth center care could save an average of $1,163 per birth (2008 constant dollars), or $11.6 million per 10,000 births per year.
Medicaid is the leading payer for maternity services. As Medicaid faces continuing cost increases and budget constraints, policy makers should consider a larger role for midwives and birth centers in maternity care for low-risk Medicaid pregnant women.
医疗补助计划支付了美国约一半的分娩费用，成本非常高。与常规产科护理相比，在分娩中心由助产士提供护理可降低医疗补助计划的成本。本研究借鉴了先前一项关于分娩中心护理结果的研究信息，以确定此类护理是否能降低低收入女性的医疗补助成本。
该研究使用了华盛顿特区家庭健康与分娩中心孕产妇和婴儿结局研究的结果。医疗补助的成本来自分娩中心数据以及其他国家产科护理成本来源。
我们估计，分娩中心护理每次分娩平均可节省1163美元（2008年不变美元），即每年每10000例分娩可节省1160万美元。
医疗补助是孕产妇服务的主要支付方。由于医疗补助面临持续的成本增加和预算限制，政策制定者应考虑让助产士和分娩中心在为低风险医疗补助孕妇提供孕产妇护理方面发挥更大作用。
