Abstract
BACKGROUND: The large number of medically indigent patients in the United States is a major concern to policymakers and may be due to recent increases in the number of uninsured people. The purpose of this study was to identify the factors that affect the amount of unpaid hospital charges for services provided to pregnant women. METHODS: Individual and hospital data were collected on a representative set of 235 pregnancy and childbirth patients with unpaid hospital charges from 28 hospitals in the state of Indiana. RESULTS: Most of these patients did not have insurance coverage (63.8%), yet the majority were employed in the public or private sector (72.3%). Over half (55.5%) of the total uncompensated care amount for this group was from the $1000 to 2499 debt category. The median charge for these patients was $1468, of which the typical hospital was able to collect only 25.5%. CONCLUSIONS: The findings support the belief that any national effort to expand the availability of health insurance coverage to women through increased employment will not totally eliminate the uncompensated care problem. The findings also indicate that rural hospitals face the uncompensated care problem mainly because a significant portion of rural patients are without adequate health insurance coverage.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blendon R. J., Aiken L. H., Freeman H. E., Kirkman-Liff B. L., Murphy J. W. Uncompensated care by hospitals or public insurance for the poor. Does it make a difference? N Engl J Med. 1986 May 1;314(18):1160–1163. doi: 10.1056/NEJM198605013141806. [DOI] [PubMed] [Google Scholar]
- Braveman P., Oliva G., Miller M. G., Schaaf V. M., Reiter R. Women without health insurance. Links between access, poverty, ethnicity, and health. West J Med. 1988 Dec;149(6):708–711. [PMC free article] [PubMed] [Google Scholar]
- Brown S. S. Drawing women into prenatal care. Fam Plann Perspect. 1989 Mar-Apr;21(2):73–80. [PubMed] [Google Scholar]
- Cagle C. S. Access to prenatal care and prevention of low birth weight. MCN Am J Matern Child Nurs. 1987 Jul-Aug;12(4):235–238. doi: 10.1097/00005721-198707000-00002. [DOI] [PubMed] [Google Scholar]
- Carter E. R. Quality maternity care for the medically indigent. MCN Am J Matern Child Nurs. 1986 Mar-Apr;11(2):85–92. doi: 10.1097/00005721-198603000-00002. [DOI] [PubMed] [Google Scholar]
- Fisher E. S., LoGerfo J. P., Daling J. R. Prenatal care and pregnancy outcomes during the recession: the Washington State experience. Am J Public Health. 1985 Aug;75(8):866–869. doi: 10.2105/ajph.75.8.866. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gold R. B., Kenney A. M. Paying for maternity care. Fam Plann Perspect. 1985 May-Jun;17(3):103–111. [PubMed] [Google Scholar]
- Hubbell F. A., Waitzkin H., Rucker L., Akin B. V., Heide M. G. Financial barriers to medical care: a prospective study in a university-affiliated community clinic. Am J Med Sci. 1989 Mar;297(3):158–162. doi: 10.1097/00000441-198903000-00005. [DOI] [PubMed] [Google Scholar]
- Marshall W. J. The uninsured: a lack of realpolitik. Ohio Med. 1989 Aug;85(8):591-2, 594. [PubMed] [Google Scholar]
- McDonald T. P., Coburn A. F. Predictors of prenatal care utilization. Soc Sci Med. 1988;27(2):167–172. doi: 10.1016/0277-9536(88)90325-5. [DOI] [PubMed] [Google Scholar]
- Murray J. L., Bernfield M. The differential effect of prenatal care on the incidence of low birth weight among blacks and whites in a prepaid health care plan. N Engl J Med. 1988 Nov 24;319(21):1385–1391. doi: 10.1056/NEJM198811243192105. [DOI] [PubMed] [Google Scholar]
- Saywell R. M., Jr, Zollinger T. W., Chu D. K., MacBeth C. A., Sechrist M. E. Hospital and patient characteristics of uncompensated hospital care: policy implications. J Health Polit Policy Law. 1989 Summer;14(2):287–307. doi: 10.1215/03616878-14-2-287. [DOI] [PubMed] [Google Scholar]
- Shearer M. Health care for the uninsured. The statistics are staggering. Mich Med. 1989 Apr;88(4):14–15. [PubMed] [Google Scholar]
- Smith V. K. Data show lack of insurance a serious problem. Mich Med. 1989 Apr;88(4):19–19. [PubMed] [Google Scholar]
- St Clair P. A., Smeriglio V. L., Alexander C. S., Celentano D. D. Social network structure and prenatal care utilization. Med Care. 1989 Aug;27(8):823–832. doi: 10.1097/00005650-198908000-00006. [DOI] [PubMed] [Google Scholar]
- Zollinger T. W., Saywell R. M., Jr, Chu D. K., Ziegert A., Woods J. R., LaBov D. A determination of institutional and patient factors affecting uncompensated hospital care. Hosp Health Serv Adm. 1991 Summer;36(2):243–256. [PubMed] [Google Scholar]
