Griffin M, Panak W F
College of Nursing, University of Rhode Island, Kingston 02881-0814, USA.
Fertil Steril. 1998 Jul;70(1):22-9. doi: 10.1016/s0015-0282(98)00107-1.
To examine the costs and outcomes of infertility-related services in Massachusetts during a time of expanded use of assisted reproductive technology (ART).
Cost data were obtained from the Massachusetts Department of Insurance Rate-Setting Commission and 9 large group insurance plans for the period 1986-1993. Utilization and success rates of ART were examined, and the cost per live delivery with the use of ART in 1993 was estimated.
The state of Massachusetts, in which access to infertility-related services has been mandated by law since 1989.
PATIENT(S): The study population consisted of 8 large health maintenance organization plans and the Blue Cross/Blue Shield indemnity plan.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Per capita infertility-related expenditures, infertility-related expenditures as a percentage of total expenditures, live deliveries per initiated ART cycle, and cost per live delivery.
RESULT(S): Expenditures for infertility services increased at a rate similar to or slower than inflation during the years 1988-1992. Increases were slowest in health maintenance organizations, probably as a result of provider arrangements. Infertility services accounted for 0.41% of total expenditures within the indemnity plan in 1993 (approximately $1.71 per contract-month). Examination of ART utilization showed no evidence of overutilization by patients with a low chance of success. The cost per live delivery with the use of ART in 1993 was $59,484.
CONCLUSION(S): Mandated infertility coverage was associated with increased use of ART but not with excessive increases in consumer cost for infertility insurance coverage.
在辅助生殖技术（ART）使用增加的时期，研究马萨诸塞州与不孕不育相关服务的成本和结果。
成本数据来自马萨诸塞州保险费率设定委员会以及1986 - 1993年期间的9个大型团体保险计划。对ART的使用情况和成功率进行了研究，并估算了1993年使用ART每例活产的成本。
自1989年起，马萨诸塞州法律规定可获得与不孕不育相关的服务。
研究人群包括8个大型健康维护组织计划和蓝十字/蓝盾赔偿计划。
无。
人均不孕不育相关支出、不孕不育相关支出占总支出的百分比、每个启动的ART周期的活产数以及每例活产的成本。
1988 - 1992年期间，不孕不育服务支出的增长速度与通货膨胀率相似或低于通货膨胀率。在健康维护组织中增长最慢，这可能是由于提供者安排的结果。1993年，赔偿计划中不孕不育服务占总支出的0.41%（约合每份合同月1.71美元）。对ART使用情况的检查表明，没有证据显示成功率低的患者存在过度使用的情况。1993年使用ART每例活产的成本为59,484美元。
法定的不孕不育保险覆盖与ART使用增加相关，但与不孕不育保险覆盖的消费者成本过度增加无关。
