Montgomery D L, Splett P L
Colorado Department of Public Health and Environment Special Supplemental Nutrition, Program for Women, Infants, and Children, Denver 80222, USA.
J Am Diet Assoc. 1997 Apr;97(4):379-85. doi: 10.1016/S0002-8223(97)00094-1.
To determine whether breast-feeding of infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with a reduction in Medicaid expenditures during the first 6 months of life; if so, to determine whether the reduction in Medicaid expenditures represents a positive economic benefit to society when WIC costs for these infants and their mothers are considered.
Cohorts of exclusively breast-fed and formula-fed infants were tracked for 6 months to compare WIC costs and Medicaid expenditures.
The sample consisted of 406 healthy infants who were breast-fed exclusively for at least 3 months and 470 healthy infants who were formula-fed exclusively. The infants, born between August 1, 1993, and December 31, 1993, were enrolled in WIC and Medicaid. COST AND BENEFIT MEASURES: WIC costs included redeemed WIC vouchers for formula and foods for infants and mothers, plus administrative expenses for 6 months, minus manufacturers' rebates for formula. Benefit was determined from Medicaid expenditures for health care initiated in the first 180 days of each infant's life. STATISTICAL AND BENEFIT-COST ANALYSES: Economic benefit was calculated as net benefit and as benefit-cost ratios. Regression techniques were used to estimate Medicaid expenditures associated with breast-feeding, adjusted for demographic and prenatal care variables.
Compared with formula-feeding, breast-feeding each infant enrolled in WIC saved $478 in WIC costs and Medicaid expenditures during the first 6 months of the infant's life, or $161 after consideration of the formula manufacturer's rebate. A Medicaid cost saving of $112 per infant was realized by the breast-feeding cohort, and Medicaid pharmacy reimbursement costs for breast-fed infants were significantly lower-half that of formula-fed infants.
The promotion of breast-feeding among low-income populations through nutrition programs such as WIC is an effective cost-containment measure.
确定参加妇女、婴儿和儿童特别补充营养计划(WIC)的婴儿进行母乳喂养是否与出生后头6个月医疗补助支出的减少相关;如果是,在考虑这些婴儿及其母亲的WIC成本时,确定医疗补助支出的减少是否对社会构成积极的经济效益。
对纯母乳喂养和人工喂养的婴儿队列进行为期6个月的跟踪,以比较WIC成本和医疗补助支出。
样本包括406名至少纯母乳喂养3个月的健康婴儿和470名纯人工喂养的健康婴儿。这些婴儿于1993年8月1日至1993年12月31日出生,参加了WIC和医疗补助计划。成本和效益衡量指标:WIC成本包括为婴儿和母亲兑换的配方奶粉和食品的WIC代金券,加上6个月的管理费用,减去配方奶粉制造商的回扣。效益由每个婴儿出生后头180天内启动的医疗保健的医疗补助支出确定。统计和效益成本分析:经济效益以净效益和效益成本比计算。使用回归技术估计与母乳喂养相关的医疗补助支出,并根据人口统计学和产前护理变量进行调整。
与人工喂养相比,参加WIC的每个婴儿在出生后头6个月进行母乳喂养可节省478美元的WIC成本和医疗补助支出,考虑配方奶粉制造商的回扣后为161美元。母乳喂养队列中的每个婴儿实现了112美元的医疗补助成本节省,母乳喂养婴儿的医疗补助药房报销成本显著较低,仅为人工喂养婴儿的一半。
通过WIC等营养计划在低收入人群中推广母乳喂养是一种有效的成本控制措施。