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Previous Volume 331:1303-1307 November 10, 1994 Number 19 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Public spending for prenatal care in the United States has been justified in recent years primarily by the cost-savings argument. Prenatal care, it is argued, can prevent the costs and medical complications associated with low birth weight; it is public health spending that pays for itself. This proposition seems intuitively reasonable and supports a popular public policy. Moreover, the findings of the body of research we consider here have given this assertion considerable weight and remarkable precision. Few other claims in medicine or in public health can be encapsulated into the statement that for every $1.00 spent, $1.70¹ (or $2.57² . . . [Full Text of this Article]

The Body of Research

Problems in Estimating the Effectiveness of Prenatal Care in Reducing the Incidence of Low Birth Weight

Noncomparable Controls

Unsupported Assumptions

Problems in Estimating the Cost of Providing Adequate Prenatal Care

Underestimation of the Cost of Comprehensive Prenatal Care

Underestimation of the Cost of Overcoming Nonfinancial Barriers to Access to Prenatal Care

Problems in Estimating Savings in the Cost of Postnatal Care

Inaccurate Determination of Costs of Postnatal Care

Oversimplification of the Relation between Changes in the Frequency of Low Birth Weight and Actual Cost Savings

Implications for Funding of Prenatal Care Programs

Address reprint requests to Dr. Connell at the Department of Health Services, SC-37, University of Washington, Seattle, WA 98195.

References

This article has been cited by other articles:

• Armstead, R., Leong, D. (1999). Outcomes Improvement: The True Mark of Quality in Managed Care. American Journal of Medical Quality 14: 202-210 [Abstract]  
• Kogan, M. D., Alexander, G. R., Jack, B. W., Allen, M. C. (1998). The Association Between Adequacy of Prenatal Care Utilization and Subsequent Pediatric Care Utilization in the United States. Pediatrics 102: 25-30 [Abstract] [Full Text]  
• Rogowski, J. (1998). Cost-effectiveness of Care for Very Low Birth Weight Infants. Pediatrics 102: 35-43 [Abstract] [Full Text]  
• Kogan, M. D., Martin, J. A., Alexander, G. R., Kotelchuck, M., Ventura, S. J., Frigoletto, F. D. (1998). The Changing Pattern of Prenatal Care Utilization in the United States, 1981-1995, Using Different Prenatal Care Indices. JAMA 279: 1623-1628 [Abstract] [Full Text]  
• Epstein, A. (1995). Performance Reports on Quality -- Prototypes, Problems, and Prospects. NEJM 333: 57-61 [Full Text]