Related Experiment Videos
Managing the future: an examination of the neonatal intensive care unit
1National Perinatal Information Center, Providence, Rhode Island 02903.
Insights
Neonatal intensive care faces economic challenges. Strategies include managed competition, cost-effectiveness, and partnerships to maintain quality care for high-risk newborns.
Area of Science:
- Neonatal intensive care
- Health care economics
- Perinatal regionalization
Background:
- Neonatal intensive care (NIC) has achieved significant successes.
- Economic pressures and competition impact NIC's altruistic foundations.
- High-cost neonatal care is particularly vulnerable to cost containment.
Purpose of the Study:
- Examine the concept of managed competition in neonatal intensive care.
- Propose strategies for neonatal units to navigate a competitive health care market.
- Ensure the preservation of perinatal regional care principles.
Main Methods:
- Analysis of the impact of competition and cost constraints on neonatal intensive care.
- Proposal of managed competition as a framework for neonatal units.
- Discussion of necessary public support and hospital partnerships.
Main Results:
- Neonatal units must balance cost-competitiveness with quality of care.
- Hospitals serving medically indigent populations require public support.
- Partnerships are essential for assuring appropriate high-risk care.
Conclusions:
- Managed competition requires careful monitoring by the public sector.
- Partnerships and public support can preserve perinatal regionalization.
- Maintaining quality and access to high-risk neonatal care is achievable.
Abstract:
The successes in neonatal intensive care have recently encountered the economic reality of the health care marketplace. Competition and cost constraints from new reimbursement formulas have affected the spirit of altruism that guided the early organization of perinatal regional care. Since high-risk neonatal care is so costly, it is more likely to be adversely affected by competition and cost containment than other inpatient services. The author proposes an examination of the concept of managed competition. Facing the reality of competition, the managers of neonatal units must strive to be cost competitive while maintaining quality of care. Hospitals with a disproportionate share of medically indigent patients must receive public support. To retain the concept of perinatal regional care, hospitals must form partnerships that assure appropriate high-risk care for the patient populations they serve. The public sector must monitor their arrangements to assure quality and access to the appropriate services by all patients in need of high-risk perinatal care. In this manner, the intent of the original perinatal regionalization concept can be preserved in an otherwise hostile competitive health care marketplace.