Health care costs associated with changing clinics and "walk-in" deliveries: evidence supporting a regionalized health information network

被引：2

作者：

Shaw, Kathryn J. ^{[2
]}

Gutierrez, Michelle ^{[1
]}

Fridman, Moshe ^{[3
]}

Gregory, Kimberly D. ^{[4
,5
,6
,7
]}

机构：

[1] AMF Consulting, Dept Obstet & Gynecol, Los Angeles, CA USA

[2] AMF Consulting, Dept Maternal Fetal Med, Los Angeles, CA USA

[3] AMF Consulting, White Mem Med Ctr, Los Angeles, CA USA

[4] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Los Angeles, CA 90048 USA

[5] Burns Allen Res Inst, Los Angeles, CA USA

[6] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[7] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2008年 / 198卷 / 06期

关键词：

continuity of prenatal care; duplication of services; cost-effectiveness of electronic medical record; quality of care; regional health information organization;

D O I：

10.1016/j.ajog.2008.03.035

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: The objective of the study was to describe the prevalence of changing clinics and "walk-in" deliveries and estimate associated health care costs. STUDY DESIGN: This was a retrospective review at an urban teaching hospital over a 6 month period. Principal outcome measures were availability of laboratory data at delivery and the number, type, and costs of duplicated tests for patients receiving various amounts of prenatal care (PNC) at our site. The prevalence of changing clinics, walk-in deliveries, and availability of records in our hospital was applied to the Los Angeles County Medicaid population to calculate the estimated cost of repeated prenatal laboratory studies. RESULTS: Of the 1120 patients delivered by our service, 50% received all PNC at our site, 27% transferred PNC to our site, and 23% of patients were walk-ins for delivery only. Medical records were unavailable in 26% of cases, requiring prenatal laboratory studies repeated. Costs varied by amount of PNC on site (range, $ 107.00-201.00). CONCLUSION: Changing clinics and walk-in deliveries are associated with significant health care costs because of redundant laboratory services and personnel costs associated with reviewing and exchanging medical records.

引用

页码：707.e1 / 707.e8

页数：8

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