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Technology-Dependent Children: Hospital v. Home Care

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U.S. Congress, Office of Technology Assessment, Technology-Dependent Children: Hospital v. Home Care—A Technical Memorandum, OTA-TM-H-38 (Washington, DC: U.S. Government Printing Office, May 1987)

This technical memorandum examines the problems of health care financing encountered by technology-dependent children. A working definition of technology dependence is provided and the prevalence of technology dependence among American children is estimated. Analysis shows that the population of technology-dependent children has increased in size over the past 25 years, and it will probably continue to increase for several more. A principal finding is that the size of the population varies dramatically with the clinical criteria used in the definition. Examination of the relative effectiveness and costs of home versus hospital care found that the cost-saving potential of home care depends to a great extent on attributes of the family and the home environment. Payment for nonhospital care is hindered by lack of coverage and poor coordination between private and public payers. Virtually all very-long-term technology-dependent children requiring a high level of nursing assistance will exceed the limits of their families’ private insurance policies and will end up on Medicaid.

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