A comparison of contraceptive procurement pre- and post-benefit change
A comparison of contraceptive procurement pre- and post-benefit change
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DOI：
10.1016/j.contraception.2007.07.006
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发表时间：
2007-11-01
期刊：
影响因子：
2.9
通讯作者：
Petitti, Diana
中科院分区：
文献类型：
--
作者：
Postlethwaite, Debbie;Trussell, James;Petitti, Diana
工作背景：2002年，加州的凯泽基金会健康计划改变了其覆盖政策，包括100%普及最有效的避孕形式和紧急避孕药。本研究旨在评估消除避孕费用作为使用的潜在障碍是否会导致大型健康计划规定和购买的避孕方法组合的变化，以及这些变化是否在理论上可以避免更多的意外怀孕。研究设计：进行了一项回顾性观察性研究，以描述在北方加州的Kaiser Permanente受益变更前后购买的可逆避孕药的组合。然后，我们估计几年的保护（），以检查是否避孕组合改变更有效的可逆的methods.Results：避孕福利的变化后，增加了28%（从2001-2002年到2003-2004年），而15-44岁的女性参加这个健康计划的人数下降了1%。宫内避孕器（IUC）和注射剂的避孕率分别上升了137%和32%，而避孕药、贴剂和避孕环的避孕率仅上升了16%。使用激素避孕药和宫内节育器的妇女的估计年均避孕失败率从7.0%下降到6.4%。结论：取消避孕费用可能会增加避孕方法和ECP的使用。(c)2007爱思唯尔公司All rights reserved.
Background: In 2002, the Kaiser Foundation Health Plan in California changed its coverage policy to include 100% universal coverage for the most effective forms of contraception and for emergency contraceptive pills (ECPs). This study sought to evaluate whether removing the cost of contraception as a potential barrier to utilization would lead to a change in the mix of contraceptive methods prescribed and purchased by a large health plan and whether those changes could theoretically result in averting a greater number of unintended pregnancies.Study Design: A retrospective observational study was conducted to describe the mix of reversible contraceptives procured before and after the benefit change at Kaiser Permanente Northern California. We then estimated couple-years of protection (CYP) to examine whether the contraceptive mix changed to more effective reversible methods.Results: After the contraceptive benefit change, CYP increased by 28% (from 2001-2002 to 2003-2004), while the number of females aged 15-44 enrolled in this health plan fell by 1%. CYP for intrauterine contraceptives (IUCs) and injectables rose by 137% and 32%, respectively, while CYP for the pill, patch and ring rose only by 16%. The estimated average annual contraceptive failure rate among women using hormonal contraceptives and IUCs declined from 7.0% to 6.4%. Purchasing of the ECP rose by 88%.Conclusion: Removal of the cost of contraception may result in increased utilization of more effective methods and ECPs. (c) 2007 Elsevier Inc. All rights reserved.