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  1. A cost and outcome model of fertility treatment in a managed care environment.

    Article - En anglais

    Objective 

    To build a financial model of a fertility practice operating under managed care.

    Design 

    Financial model in Microsoft Excel (Redmond, Washington) Setting : University-affiliated infertility practice, assuming primary care referral of patients and total revenue a function of the capitation contract.

    Patient (s) 

    Female infertility patients and their partners with assumed mean age of 35 years.

    Main Outcome Measure (s) 

    Breakeven capitation rate.

    Result (s) 

    Every other month ovulation induction produced the lowest breakeven capitation rates in the model.

    Breakeven capitation rates increased from $0.85 up to $4.70 per member per month as utilization increased from 0.1% to 1%. of health plan members.

    Decreasing the cost of an IVF-ET cycle $2,050 decreased breakeven capitation rates from $0.05 up to $0.80 per member per month as utilization of fertility services increases from 0.1% to 1% of health plan members.

    Decreasing average yearly pregnancy rate from 56% to 41%. increased breakeven capitation rate from $0.10 to $0.80 per member per month across similar utilization.

    The average cost of pregnancy per year ranged from $6,787 to $21,075.

    Conclusion (s) 

    As utilization of fertility services increases, cost reductions no longer exist to offset increasing breakeven capitation rates.

    Financial modeling, using actual data, can evaluate any medical decision in terms of outcome and the cost of that outcome. (...)

    Mots-clés Pascal : Procréation assistée, Soin intégré, Analyse coût, Economie santé, Modèle, Prise décision, Médecin, Etats Unis, Amérique du Nord, Amérique, Personnel sanitaire, Homme

    Mots-clés Pascal anglais : Assisted procreation, Managed care, Cost analysis, Health economy, Models, Decision making, Physician, United States, North America, America, Health staff, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0041137

    Code Inist : 002B20A04. Création : 21/05/1997.