The costs and financing of perinatal care in the United States

Am J Public Health. 1994 Sep;84(9):1473-8. doi: 10.2105/ajph.84.9.1473.


Objectives: The purpose of this study was to estimate the aggregate annual costs of maternal and infant health care and to describe the flow of funds that finance that care.

Methods: Estimates of costs and financing based on household and provider surveys, third-party claims data, and hospital discharge data were combined into a single, best estimate.

Results: The total cost of perinatal care in 1989 was $27.8 billion, or $6850 per mother-infant pair. Payments made directly by patients or third parties for this care totaled $25.4 billion, or about 7% of personal health care spending by the nonaged population. Payments were less than costs because they did not include a value for direct delivery care or for bad debt and charity care, which accounted for $2.4 billion. Private insurance accounted for about 63% of total payments, and Medicaid accounted for 17% of the total.

Conclusions: National health reform would provide windfall receipts to hospitals, which would receive payment for the considerable bad debt and charity care they provide. Reform might also provide short-term gains to providers as private payment rates are substituted for those of Medicaid.

MeSH terms

  • Adult
  • Child Health Services / economics*
  • Data Collection / methods
  • Female
  • Financing, Organized
  • Health Care Costs*
  • Humans
  • Infant, Newborn
  • Insurance, Health, Reimbursement
  • Maternal Health Services / economics*
  • Medicaid
  • Pregnancy
  • United States