Joyce T, Corman H, Grossman M
National Bureau of Economic Research, New York, New York.
Med Care. 1988 Apr;26(4):348-60. doi: 10.1097/00005650-198804000-00004.
This study compares the cost effectiveness of various health inputs and government programs in reducing race-specific neonatal mortality or death in the first 27 days of life. Approximately two thirds of all infant deaths occur within this period. The programs and inputs at issue are teenage family planning use; the supplemental food program for women, infants, and children (WIC); use of community health centers and maternal and infant care projects; abortion; prenatal care; and neonatal intensive care. Using an economic model of the family as the analytic framework, effectiveness is determined by using ordinary least squares and two-stage least squares to estimate infant health production functions across large counties in the United States in 1977. Estimates of costs are from a number of published sources. We find the early initiation of prenatal care to be the most cost-effective means of reducing the neonatal mortality rate for blacks and whites. Moreover, blacks benefit more per dollar of input use than whites. Neonatal intensive care, although the most effective means of reducing neonatal mortality rates, is one of the least cost-effective strategies.
本研究比较了各种卫生投入和政府项目在降低特定种族新生儿死亡率（即出生后27天内的死亡）方面的成本效益。所有婴儿死亡中约三分之二发生在此期间。所讨论的项目和投入包括青少年计划生育的使用；妇女、婴儿和儿童补充食品计划（WIC）；社区卫生中心和母婴护理项目的使用；堕胎；产前护理；以及新生儿重症监护。以家庭经济模型作为分析框架，通过使用普通最小二乘法和两阶段最小二乘法来估计1977年美国大县的婴儿健康生产函数，从而确定有效性。成本估计来自多个已发表的来源。我们发现，早期开始产前护理是降低黑人和白人新生儿死亡率最具成本效益的手段。此外，每使用一美元投入，黑人比白人受益更多。新生儿重症监护虽然是降低新生儿死亡率最有效的手段之一，但却是成本效益最低的策略之一。
