Infertility service use among US women: 1995 and 2002
Infertility service use among US women: 1995 and 2002
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DOI：
10.1016/j.fertnstert.2008.10.049
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发表时间：
2010-02-01
影响因子：
6.7
通讯作者：
Stephen, Elizabeth Hervey
中科院分区：
文献类型：
--
作者：
Chandra, Anjani;Stephen, Elizabeth Hervey
目的：根据妇女的个体特征，研究不孕症医疗服务的使用趋势。设计：汇集了全国家庭增长调查的两个周期（1995年和2002年）的数据，这是一项定期进行的，具有全国代表性的15-44岁妇女的横断面调查。参与者：分析样本由2005名22-44岁有生育问题的女性组成。干预:没有。主要结局指标：曾经使用过不孕不育服务，使用的服务水平最高。结果(S): 1995年至2002年期间，22-44岁的不孕不育妇女使用不孕服务的次数继续与年龄较大、未生育、正式婚姻状况和较高的社会经济水平（教育、家庭收入和私人健康保险）密切相关。在这些因素中，种族和西班牙裔与总体服务使用或最高服务使用水平没有显著关联。在控制了这些个体特征的构成变化之后，从1995年到2002年，服务的总体使用率略有下降。在最高水平的服务方面，没有发现调查年份的影响。结论：不孕不育妇女使用不孕不育服务与社会经济因素密切相关。这些因素的“门槛效应”已向上转移到接受诸如辅助生殖技术等更昂贵的服务。这些较高水平的服务在生育能力受损妇女的一般人口样本中所报告的服务中仍然是相对较小的一部分。(Fertil Steril （R) 20 10:93:725-36, (C)2010年美国生殖医学学会。）
Objective: To examine trends in use Of Medical services for infertility, by individual characteristics of women.Design: Pooled data from two cycles (1995 and 2002) of the National Survey of Family Growth, a periodically conducted, nationally representative, cross-sectional survey of women 15-44 years of age.Participant(s): The analysis sample was composed of 2,005 women 22-44 years of age with Current fertility problems.Intervention(s): None.Main Outcome Measure(s): Ever having used infertility services, and highest level of services used.Result(S): Between 1995 and 2002, ever-use of infertility services by fertility-impaired women age 22-44 years continued to be closely associated with older age, nulliparity, formal marital status, and higher socioeconomic stains (education, household income, and private health insurance). Net of these factors, race and Hispanic origin, showed no significant association with either the use of services overall or the highest level of services used. After controlling for compositional changes in these individual characteristics, a slight decline was seen in ever-use of services overall from 1995 to 2002. No effect of Survey year was noted in the highest level of services.Conclusion(s): Infertility service use among fertility-impaired women remains closely tied with socioeconomic factors. The "threshold effect" of these factors has shifted upward to the receipt of more costly services such as assisted reproductive technologies. These higher level services remain a relatively small fraction of the services reported in a general Population sample of fertility-impaired women. (Fertil Steril (R) 20 10:93:725-36, (C)2010 by American Society for Reproductive Medicine.)