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  • Title: Supply and demand for neonatal intensive care: trends and implications.
    Author: Schwartz RM.
    Journal: J Perinatol; 1996; 16(6):483-9. PubMed ID: 8979190.
    Abstract:
    OBJECTIVE: Access to high-risk newborn care is determined by supply of services, demand, and financing. Major changes in health care have occurred since the advent of perinatal regionalization in the mid-1970s. This article explores access from the point of view of the supply and demand for neonatal intensive care within the changing financing environment. STUDY DESIGN: An analysis was done of the 1983, 1989, and 1991 American Hospital Association survey data, combined with birth data from the National Center for Health Statistics. RESULTS: By 1991 supply of hospital-based high-risk newborn care exceeded demand; nationally, there were roughly 300,000 excess bed-days available in 1991. Regional figures revealed that these estimates are, if anything, conservative. CONCLUSIONS: Payers are increasingly price sensitive and have the ability to shift blocks of patients from one facility to another. A surplus encourages a shift of patients to low-price locations. Differentiation of quality and monitoring will become an important means of ensuring access to high-quality care in a surplus environment.
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