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POSTPARTUM MANDATE--ESTIMATED COSTS AND BENEFITS

产后任务——估计成本和收益

基本信息

批准号：
2032164
负责人：
JESSE D MALKIN
金额：
$ 3万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
1996
资助国家：
美国
起止时间：
1996-09-01 至 1998-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2032164
关键词：
clinical research health care cost /financing health care policy health care professional practice health care service availability health care service evaluation hospital length of stay human data patient care management pediatrics postpartum women's health

项目摘要

The United States is engaged in an important debate about whether commercial insurers should be required to pay for longer postpartum stays. Supporters of the mandate contend that it is necessary to protect the health and safety of mothers and their newborns, that it will save money by reducing the number of readmissions, and that it is "the right thing to do." Critics respond that there is no convincing evidence that early discharge represents an excessive danger to mothers and newborns, and that the same amount of resources applied to other health measures would produce more health at a lower cost. The purpose of this study is to evaluate the costs and health consequences of mandates requiring insurers to pay for a minimum 48-hours hospital stay for mothers and newborns after a vaginal delivery or 96 hours following a Cesarean section. To evaluate the efficacy of this mandate, three related policy questions are addressed. First, what are the health benefits of the mandate? Second, how much does the mandate cost? And, third, is the mandate cost-effective? I propose to answer these questions using a data set from the Management and Outcomes of Childbirth PORT. This data set contains an extremely rich array of clinical, sociodemographic, insurance, hospital, physician and charge variables for every birth in Washington state in 1989 and 1990. It contains 159,311 total records, of which 133,589 records have perfect matches between hospital discharge records and birth certificate records. Health benefits will be estimated by assessing the relationship between length of postpartum stay and the readmission rate. Costs will be estimated using the ratio of cost to charges method based on hospital- level data from the Medicare Cost Reports. The final results will inform policymakers in Washington and in other states where the mandate is being considered.

美国正在进行一场重要的辩论，商业保险公司应该被要求支付更长的产后留下来授权的支持者认为，有必要保护母亲和新生儿的健康和安全，他说，这是一个很大的问题，也是一个很大的问题。要做的事情。“批评者回应说，没有令人信服的证据表明，过早出院对母亲和新生儿来说是一种过度的危险，同样数量的资源也用于其他健康措施以更低的成本创造更多的健康。本研究的目的是评估成本和健康要求保险公司支付最低48小时保险费的规定的后果阴道分娩后母亲和新生儿的住院时间或96 在剖腹产后的几个小时。为了评估这种治疗的效果，根据任务规定，解决了三个相关的政策问题。首先，这项任务的健康益处第二，成本？第三，任务是否具有成本效益？我建议使用管理层提供的数据集来回答这些问题。分娩港的结局这个数据集包含了极其丰富的一系列临床、社会人口、保险、医院、医生和在1989年和1990年，华盛顿州的每一个新生儿的收费都是可变的。它包含159，311条记录，其中133，589条记录具有完美的出院记录和出生证明记录的匹配将通过评估以下因素之间的关系来估计健康益处：产后住院时间和再入院率。成本将根据医院的成本与收费比率方法估计- 医疗费用报告中的数据。最终结果将告知华盛顿和其他州的政策制定者考虑了