Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States of America.
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America.
PLoS One. 2020 May 29;15(5):e0233411. doi: 10.1371/journal.pone.0233411. eCollection 2020.
The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program.
The Baby Bridge program was developed to promote timely, consistent and high quality early therapy services for high-risk infants following neonatal intensive care unit (NICU) discharge. Key features of the Baby Bridge program were defined as: 1) having the therapist establish rapport with the family while in the NICU, 2) scheduling the first home visit within one week of discharge and continuing weekly visits until other services commence, 3) conducting comprehensive assessments to inform targeted interventions by a skilled, single provider, and 4) using a comprehensive therapeutic approach while collaborating with the NICU medical team and community therapy providers. The Baby Bridge program was implemented with infants hospitalized in an urban Level IV NICU from January 2016 to January 2018. The number of infants enrolled increased gradually over the first several months to reach the case-load capacity associated with one full-time therapist by mid-2017. Costs of the therapists delivering Baby Bridge services, travel, and equipment were tracked and compared with claim records of participants. The operational cost of Baby Bridge programming at capacity was estimated based on the completed and anticipated claims and reimbursement of therapy services as a means to inform possible scale-ups of the program.
In 2016, the first year of programming, the Baby Bridge program experienced a loss of $26,460, with revenue to the program totaling $11,138 and expenses totaling $37,598. In 2017, the Baby Bridge program experienced a net positive income of $2,969, with revenues to the program totaling $53,989 and expenses totaling $51,020. By Spring 2017, 16 months after initiating Baby Bridge programming, program revenue began to exceed cost. It is projected that cumulative revenue would have exceeded cumulative costs by January 2019, 3 years following implementation. Net annual program income, once scaled up to capacity, would be approximately $16,308.
There were initial losses during phase-in of Baby Bridge programming associated with operating far below capacity, yet the program achieved sustainability within 16 months of implementation. These costs related to implementation do not consider the potential cost reduction due to mitigated health burden for the community and families, particularly due to earlier receipt of therapy services, which is an important area for further inquiry.
本项目旨在确定收入和成本随时间的变化情况，以评估婴儿桥项目的可持续性。
婴儿桥项目旨在为新生儿重症监护病房（NICU）出院后的高危婴儿提供及时、一致和高质量的早期治疗服务。婴儿桥项目的主要特点包括：1）让治疗师在 NICU 与家庭建立关系，2）在出院后第一周内安排第一次家访，并继续每周访问，直到开始其他服务，3）进行全面评估，以便由一名熟练的单一提供者提供有针对性的干预措施，以及 4）在与 NICU 医疗团队和社区治疗提供者合作的同时，采用全面的治疗方法。婴儿桥项目于 2016 年 1 月至 2018 年 1 月在城市四级 NICU 住院的婴儿中实施。最初几个月，婴儿的入组人数逐渐增加，到 2017 年年中，达到了一名全职治疗师的工作量。治疗师提供婴儿桥服务、差旅和设备的成本被跟踪，并与参与者的索赔记录进行比较。根据已完成和预期的治疗服务索赔和报销情况，估算了婴儿桥项目满负荷运营的运营成本，以便为项目的可能扩大提供信息。
2016 年，即项目的第一年，婴儿桥项目亏损 26460 美元，项目总收入为 11138 美元，支出为 37598 美元。2017 年，婴儿桥项目实现了 2969 美元的净正收入，项目总收入为 53989 美元，支出为 51020 美元。到 2017 年春天，即启动婴儿桥项目 16 个月后，项目收入开始超过成本。预计到 2019 年 1 月，即项目实施 3 年后，累计收入将超过累计成本。项目满负荷运营后的年净收入约为 16308 美元。
婴儿桥项目在投入使用初期出现亏损，这与远低于满负荷运营有关，但该项目在实施后 16 个月内实现了可持续性。这些与实施相关的成本不考虑由于更早地接受治疗服务而减轻社区和家庭的健康负担所带来的潜在成本降低，这是一个需要进一步研究的重要领域。
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