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孕产妇导航:为了共同的利益。

Maternal navigation: for the common good.

机构信息

435 N Michigan Ave #813, Chicago, IL 60611. Email:

出版信息

Am J Manag Care. 2024 Sep;30(Spec No. 10):SP745-SP750. doi: 10.37765/ajmc.2024.89608.

Abstract

The US faces a maternal health crisis as overall maternal mortality rates continue to worsen. HHS, in its Healthy People 2030 report, indicates that women in the US are more likely to die from childbirth than are women in other developed countries. The cost of the maternal health crisis and its associated morbidities is estimated to be $32.3 billion from conception to 5 years postpartum, with $18.7 billion in medical costs and $13.6 billion in nonmedical costs. Under the current health care reimbursement system, health care providers alone have little short-term incentive to bear the cost for solutions or prevention strategies that could change the social and cultural factors affecting maternal outcomes. This article provides an overview of the crisis, along with its economic and societal costs, and the role of prenatal care and premature birth in this escalating problem. The article then proposes maternal navigation for pregnant patients who chronically miss prenatal care appointments as one way to reduce premature births and associated health care costs. Through intentional and focused investment in maternal navigation by payers and providers together, health outcomes can be improved and disparities can be reduced. As a result, payer and provider costs are reduced and the interests of all parties are advanced. A connected system of support that improves health outcomes and reduces health care costs for the most at-risk patients is an essential response to a crisis that affects not only the individual but also society.

摘要

美国面临着母婴健康危机,因为整体母婴死亡率持续恶化。HHS 在其《健康人民 2030 报告》中指出,美国女性死于分娩的可能性比其他发达国家的女性更高。母婴健康危机及其相关发病率的成本估计为从受孕到产后 5 年的 323 亿美元,其中 187 亿美元为医疗费用,136 亿美元为非医疗费用。在当前的医疗保健报销系统下,医疗保健提供者自身几乎没有短期激励来承担可能改变影响母婴结局的社会和文化因素的解决方案或预防策略的成本。本文概述了这场危机及其经济和社会成本,以及产前护理和早产在这一问题不断升级中的作用。然后,本文提出对经常错过产前护理预约的孕妇进行母婴导航,作为减少早产和相关医疗保健费用的一种方法。通过支付方和提供者共同对母婴导航进行有目的和有重点的投资,可以改善健康结果并减少差异。结果是降低了支付方和提供者的成本,同时也促进了各方的利益。为最需要的患者提供改善健康结果和降低医疗保健成本的支持系统是对不仅影响个人而且影响社会的危机的必要回应。

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