Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy
Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy
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DOI：
10.1016/j.contraception.2013.08.004
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发表时间：
2013-12-01
期刊：
影响因子：
2.9
通讯作者：
Smith, Kenneth
中科院分区：
文献类型：
--
作者：
Borrero, Sonya;Zite, Nikki;Smith, Kenneth
目的：医疗补助绝育政策，包括从同意到绝育程序之间的强制性30天等待期，为许多希望接受公共资金绝育的妇女提供了重要的后勤保障。我们的目标是估计意外怀孕的数量和由于医疗补助政策障碍而导致的未满足绝育请求的相关成本。研究设计：我们从医疗保健支付者的角度构建了一个成本效益模型，以确定与假想的修订政策相比，当前医疗补助绝育政策在一年时间范围内的增量成本，在该政策中，希望产后绝育的女性将面临显著减少的障碍。模型中潜在结果的概率估计基于公布的来源；医疗补助资助的绝育和医疗补助覆盖的生育的成本分别基于医疗补助统计信息系统和古特马赫研究所的数据。结果：随着修订的医疗补助绝育政策的实施，我们估计满足绝育请求的数量将增加45%，从满足绝育请求的所有女性的53.3%增加到77.5%。每年，这一增长可能会导致超过2.9万例意外怀孕，节省2.15亿美元。结论：修订后的医疗补助绝育政策可能会尊重女性的生育决定，减少意外怀孕的数量，并节省大量公共资金。影响：与当前的联邦医疗补助绝育政策相比，这项假想的修订政策减少了希望获得公共资金的女性的后勤障碍，产后绝育可能每年避免超过2.9万例意外怀孕，从而每年节省2.15亿美元的成本。由爱思唯尔公司出版。
Objective: Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical bathers for many women who desire publicly funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers.Study Design: We constructed a cost-effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a postpartum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively.Results: With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved.Conclusion: A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies and save a significant amount of public funds.Implication: Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly funded, postpartum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to cost savings of $215 million each year. Published by Elsevier Inc.