Do increases in payments for obstetrical deliveries affect prenatal care ?
Raising fees is one of the primary means that State Medicaid Programs employ to maintain provider participation.
While a number of studies have sought to quantify the extent to which this policy retains or attracts providers, few have looked at the impact of these incentives on patients.
In this study, the authors used Medicaid claims data to examine changes in volume and site of prenatal care among women who delivered babies after the Maryland Medicaid Program raised physician fees for deliveries 200 percent at the end of its 1986 fiscal year.
Although the State's intent was to stabilize the pool of nonhospital providers who were willing to deliver Medicaid babies, it was also hoped that women would benefit through greater access to prenatal care, especially care rendered in a nonhospital setting.
The authors'hypotheses were that (a) the fee increase for obstetrical deliveries would result in an increase in prenatal visits by women on Medicaid, and (b) the fee increase would lead to a shift in prenatal visits from hospital to community based providers.
Though significant increases in the number of prenatal visits occurred for women who lived outside of Baltimore City, it is difficult to attribute these changes solely to the fee increase.
Where an effect was observed, it appeared to be greatest in nonurban areas of the State, probably because coordination of care by fewer Medicai.
Mots-clés Pascal : Salaire, Augmentation, Personnel sanitaire, Accessibilité, Soin, Prénatal, Obstétrique, Homme, Système santé, Maryland, Medicaid, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Wage, Increase, Health staff, Accessibility, Care, Prenatal, Obstetrics, Human, Health system, Maryland, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0434759
Code Inist : 002B30A01B. Création : 01/03/1996.