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"Drive-through deliveries" do not result in the cost savings often touted by their advocates, according to results of an IU study which is the lead article in the current issue of Medical Care Research and Review. The study was completed by researchers at the School of Public and Environmental Affairs (SPEA).
SPEA professors Ming Tai-Seale, Marc Rodwin and Gerard Wedig took advantage of a natural experiment--the implementation of Medicaid managed care in Indiana--to examine the empirical evidence on the impact of shortened length-of-stay for childbirth and labor. Studying 5,585 vaginal births between 1993 and 1995, the professors found that while the length of stay at the hospital for maternity care was reduced by 21 percent, actual savings were only $280 per delivery, or only 12 percent of total hospital costs before managed care. Further, when the full costs of an earlier discharge were taken into consideration, including costs to patients and their families, the savings associated with a shortened hospital stay may be less.
Previous estimates have placed the savings of discharging a new mother and her child without a second day of maternity treatment at $1,000 to $2,000. Tai-Seale said the calculation of these savings often has been based on average per-day costs. "But the truth is, given the intensity of the care and the services provided during that stay, the first day is when it is most intense. The second day is more for recuperation and requires fewer resources," she said. "The woman simply needs recuperation and not much more than Jell-O from the hospital cafeteria. The majority of the costs are incurred during the first day of her stay."
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