Long S H, Marquis M S, Harrison E R
RAND, Washington, DC 20037.
Am J Public Health. 1994 Sep;84(9):1473-8. doi: 10.2105/ajph.84.9.1473.
The purpose of this study was to estimate the aggregate annual costs of maternal and infant health care and to describe the flow of funds that finance that care.
Estimates of costs and financing based on household and provider surveys, third-party claims data, and hospital discharge data were combined into a single, best estimate.
The total cost of perinatal care in 1989 was $27.8 billion, or $6850 per mother-infant pair. Payments made directly by patients or third parties for this care totaled $25.4 billion, or about 7% of personal health care spending by the nonaged population. Payments were less than costs because they did not include a value for direct delivery care or for bad debt and charity care, which accounted for $2.4 billion. Private insurance accounted for about 63% of total payments, and Medicaid accounted for 17% of the total.
National health reform would provide windfall receipts to hospitals, which would receive payment for the considerable bad debt and charity care they provide. Reform might also provide short-term gains to providers as private payment rates are substituted for those of Medicaid.
本研究旨在估算母婴保健的年度总成本，并描述为该保健提供资金的资金流向。
基于家庭和提供者调查、第三方索赔数据以及医院出院数据得出的成本和融资估算被整合为一个单一的最佳估算值。
1989年围产期保健的总成本为278亿美元，即每对母婴6850美元。患者或第三方直接为此项保健支付的费用总计254亿美元，约占非老年人口个人医疗保健支出的7%。支付金额低于成本，因为其中未包括直接分娩护理、坏账和慈善护理的价值，而这部分价值为24亿美元。私人保险约占总支付额的63%，医疗补助占总额的17%。
国家医疗改革将为医院带来意外之财，因为医院将获得对其提供的大量坏账和慈善护理的支付。随着私人支付率取代医疗补助的支付率，改革还可能为提供者带来短期收益。
