Quantifying the impact of targeted regulation of abortion provider laws on US abortion rates: a multi-state assessment
Quantifying the impact of targeted regulation of abortion provider laws on US abortion rates: a multi-state assessment
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DOI：
10.1016/j.contraception.2019.06.003
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发表时间：
2019-11-01
期刊：
影响因子：
2.9
通讯作者：
Harper, Sam
中科院分区：
文献类型：
--
作者：
Austin, Nichole;Harper, Sam
目的：在本文中，我们估计两个共同的TRAP（有针对性的监管堕胎提供者）法律对堕胎率的平均影响，使用一个新的纵向数据库的国家级policy shifts.Study设计：我们合并了几个来源的政策，堕胎，和社会人口数据从1991-2014。我们使用了差异中的差异设计来控制时间固定的州一级特征和影响所有州堕胎趋势的共同因素，以及可能影响TRAP执行和堕胎率的时变州一级因素。我们使用广义线性模型与集群稳健的标准误，以获得我们的estimation.Results：流动手术中心（ASC）的法律执行减少了1.25堕胎每1000名妇女年龄在15-44（95%CI：-3.39，.89），承认特权法使15-44岁妇女的堕胎率增加了0.57/1000（95% CI：-0.68，1.83），但两种效应均无统计学差异。我们的研究结果是强大的纳入协变量和各种敏感性analysis.Conclusion：我们的研究结果表明，ASC和承认特权法并没有，平均而言，导致堕胎率有意义的变化。(C)2019爱思唯尔公司All rights reserved.
Objectives: In this paper, we estimate the average effect of two common TRAP (targeted regulation of abortion providers) laws on abortion rates using a novel longitudinal database of state-level policy shifts.Study design: We merged several sources of policy, abortion, and sociodemographic data from 1991-2014. We used a difference-in-differences design to control for time-fixed state-level characteristics and common factors affecting abortion trends across all states, as well as measured time-varying state-level factors that may impact TRAP enforcement and abortion rates. We used generalized linear models with cluster-robust standard errors to obtain our estimates.Results: Enforcement of ambulatory surgical center (ASC) laws reduced the abortion rate by 1.25 abortions per 1000 women aged 15-44 (95% CI: -3.39,.89), and admitting privilege laws increased the abortion rate by .57 abortions per 1000 women aged 15-44 (95% CI: -.68, 1.83), but neither effect was statistically distinguishable from zero. Our findings were robust to the inclusion of covariates and various sensitivity analyses.Conclusion: Our results suggest that ASC and admitting privilege laws did not, on average, lead to a meaningful change in abortion rates. (C) 2019 Elsevier Inc. All rights reserved.