Impact of Financial Incentives for Prenatal Care on Birth Outcomes and Spending

Objective. To evaluate the impact of offering US$100 each to patients and their obstetricians or midwives for timely and comprehensive prenatal care on low birth weight, neonatal intensive care admissions, and total pediatric health care spending in the first year of life. Data Sources/Study Setting...

Full description

Saved in:

Bibliographic Details
Published in:	Health services research 2009-10, Vol.44 (5p1), p.1465-1479
Main Authors:	Rosenthal, Meredith B., Li, Zhonghe, Robertson, Audra D., Milstein, Arnold
Format:	Article
Language:	eng
Subjects:	Adult Antenatal care birth outcomes Childbirth Company business management Compensation and benefits Costs, Use and Outcomes Economic aspects Economic incentives Expenditure Female financial incentives First year Health care expenditures Health care industry Health Expenditures - statistics & numerical data Health insurance Health Services Research Hispanic Americans - statistics & numerical data Humans Incentives Infant, Low Birth Weight Infant, Newborn Intensive Care, Neonatal - statistics & numerical data Low birth weight managed care Managed Care Programs - economics Managed Care Programs - organization & administration Management Monetary incentives Patient compliance Patient Compliance - statistics & numerical data Patient outcomes Physicians Poverty - statistics & numerical data Practice Pregnancy Pregnancy Complications - ethnology Pregnancy Outcome - economics Pregnancy Outcome - ethnology Prenatal care Prenatal Care - economics Prenatal Care - organization & administration Public health Quality management Services Studies United States
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Objective. To evaluate the impact of offering US$100 each to patients and their obstetricians or midwives for timely and comprehensive prenatal care on low birth weight, neonatal intensive care admissions, and total pediatric health care spending in the first year of life. Data Sources/Study Setting. Claims and enrollment profiles of the predominantly low‐income and Hispanic participants of a union‐sponsored, health insurance plan from 1998 to 2001. Study Design. Panel data analysis of outcomes and spending for participants and nonparticipants using instrumental variables to account for selection bias. Data Collection/ion Methods. Data provided were analyzed using t‐tests and chi‐squared tests to compare maternal characteristics and birth outcomes for incentive program participants and nonparticipants, with and without instrumental variables to address selection bias. Adjusted variables were analyzed using logistic regression models. Principle Findings. Participation in the incentive program was significantly associated with lower odds of neonatal intensive care unit admission (0.45; 95 percent CI, 0.23–0.88) and spending in the first year of life (estimated elasticity of −0.07; 95 percent CI, −0.12 to −0.01), but not low birth weight (0.53; 95 percent CI, 0.23–1.18). Conclusion. The use of patient and physician incentives may be an effective mechanism for improving use of recommended prenatal care and associated outcomes, particularly among low‐income women.
ISSN:	0017-9124 1475-6773