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Studies Examine Cost of Inadequate Prenatal Care to Business

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WASHINGTON--American businesses will spend more than $4 billion this year on medical care for women and children who lack health insurance or who are Medicaid recipients, a study released here last week at the "Corporate Summit for Children'' concludes.

The study was one of two sponsored by the CIGNA Corporation to examine the relationship between prenatal care, infant health problems, and the financial costs of both to American corporations. The financial-services company was also a summit sponsor.

The studies "confirm what pediatricians know on a day-to-day basis,'' Dr. Antoinette Parisi Eaton, the immediate past president of the American Academy of Pediatrics, said at a press conference Thursday.

Conducted by the Center for Health Policy Studies in Columbia, Md., the first study examined the case histories of 284,000 women who gave birth in New York State in 1989.

While both insured and uninsured women gave birth to similar percentages of low-birthweight babies, the study found, infant-mortality rates for uninsured women were 55 percent higher than those for insured women.

The study also concludes that women with private health insurance tended to seek prenatal care earlier in their pregnancies than either uninsured women or Medicaid recipients.

Of the women identified at the time of their child's birth as substance abusers, researchers found that 57.7 percent were Medicaid recipients, 32.4 percent lacked health insurance, and 9.9 percent were covered by private insurance.

In addition to cost, the study notes that uninsured women face numerous other obstacles to gaining access to prenatal care, including inadequate education, a lack of transportation and child-care services, language barriers, and the unavailability of doctors and clinics that accept nonpaying clients and Medicaid recipients.

The study recommends that more research be conducted to examine the relationship between unhealthy maternal behaviors--such as poor nutrition and substance abuse--and infant-mortality rates and other birth-related health problems.

It also calls for further study of the relationship between differences in pre-and post-natal medical practice and birth outcomes.

Second Study

The second study, conducted by researchers at Georgia State University, examined 59,000 mothers and their children who were insured by the ãéçîá Corporation from September 1989 to August 1991.

The researchers found that one in four children was born with some type of health problem, and that this group accounted for 40 percent of the total medical expenditures of the survey group, or some $304 million.

The study also found that 1 in 22 children was born with severe health problems, most of which were associated with premature delivery, and that 1 in 12 suffered moderate problems, such as perinatal infections and respiratory illnesses.

According to the researchers, "problem births'' resulted in an average of $20,500 in hospital bills, twice as much as the births of healthy children. Extremely premature and low-weight births cost an average of $77,000.

High medical costs for premature babies and those born with "significant'' health problems frequently continued for at least a year following the child's birth, the study reports.

The Georgia researchers estimate that the health-care expenses of problem births cost employers and workers a total of about $5.6 billion in 1990, about 3 percent of after-tax corporate profits during the same period.

In addition to a moral and ethical imperative, noted the commission's chair, Gov. Lawton Chiles of Florida, businesses will face "astronomical'' long-term costs if they fail to provide adequate health insurance and access to prenatal care for their employees and their communities.

"The majority of this burden could be lifted by preventative care,'' he said.

Copies of both studies are available by calling the CIGNA Corporation in Hartford, Conn., at (203) 726-8340.

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