The Impact of Out-of-Pocket Costs on the Use of Intrauterine Contraception Among Women With Employer-sponsored Insurance

Pace, Lydia E.; Dusetzina, Stacie B.; Fendrick, A. Mark; Keating, Nancy L.; Dalton, Vanessa K.

doi:10.1097/mlr.0b013e3182a97b5d

Cited by 58 publications

(43 citation statements)

References 30 publications

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“…18,19 As a whole, the program has observed a steady increase in IUD and implant provision. 20 Our findings demonstrate that 42% of the California practices that provide IUDs can offer same-day placement, which is substantially higher than the 7% reported in 2006 among a similar sample 14 and higher than the 13% reported more recently among a national sample of obstetrician-gynecologists, 12 suggesting improvements in health care provider capacity.…”

Section: Discussionmentioning

confidence: 94%

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision

Biggs

Harper

Brindis

2015

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 94%

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision

Biggs

Harper

Brindis

2015

Obstetrics &Amp; Gynecology

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“…For instance, our previous work demonstrated that lower out-of-pocket costs are associated with an increase in IUD use among commercially insured women. (31) By requiring insurance coverage for long-acting contraceptive methods, women with chronic medical conditions may have improved access to safe, highly effective methods. Further research on the impact of the ACA on women’s health should include an assessment of its effects on the delivery of all preventive women’s health services, including contraceptive services.…”

Section: Discussionmentioning

confidence: 99%

Receipt of Prescription Contraception by Commercially Insured Women With Chronic Medical Conditions

Denoble

Hall

et al. 2014

Obstetrics &Amp; Gynecology

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Objective To assess differences in receipt of prescription contraception among women with and without chronic medical conditions. Methods This observational study used 3 years of administrative claims records for insured women aged 21–45 years who were enrolled in a commercial insurance company in Michigan between 2004 and 2009. Women were considered to have a chronic medical condition if they had at least two claims for one of the following conditions, in order of prevalence in our study population: hypertension, asthma, hypothyroidism, diabetes, obesity, rheumatoid arthritis, inflammatory bowel disease, or systemic lupus erythematosus. Our primary outcome was receipt of prescription contraception, defined by a pharmacy claim or diagnostic or procedural code. We used multivariable logistic regression to estimate the association of chronic condition status with the odds of receiving prescription contraception within 3 years, adjusting for age, community-level socioeconomic status, total outpatient visits, and cervical cancer screening. Results Of 11,649 women studied, 16.0% (n=1,862) had at least one of the chronic conditions we considered. Of those with a chronic condition, 33.5% (n=623) received prescription contraception during the 3-year study period compared to 41.1% (n=4,018) of those without a chronic condition (p<0.001). After adjusting for covariates, women with a chronic condition remained less likely than women without a chronic condition to have received prescription contraception (adjusted odds ratio=0.85; 95% CI 0.76, 0.96; p=0.010). Conclusion Despite a greater risk for adverse outcomes with an unplanned pregnancy, women with these chronic conditions were less likely to receive prescription contraception.

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“…In a study among women seeking abortion services, 24% reported the cost of contraception as the reason they did not use a method to prevent pregnancy 92. Another study demonstrated that among women with employer-sponsored health insurance, rates of IUD initiation were higher when cost-sharing was lower, even after accounting for cost-sharing levels of other contraceptive methods 93. These studies are concordant showing that when cost is removed, women are more likely to use long-acting options such as IUDs for contraception.…”

Section: Specific Considerationsmentioning

confidence: 99%

Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States

Yoost¹

2014

PPA

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Three intrauterine devices (IUDs), one copper and two containing the progestin levonorgestrel, are available for use in the United States. IUDs offer higher rates of contraceptive efficacy than nonlong-acting methods, and several studies have demonstrated higher satisfaction rates and continuation rates of any birth control method. This efficacy is not affected by age or parity. The safety of IUDs is well studied, and the risks of pelvic inflammatory disease, perforation, expulsion, and ectopic pregnancy are all of very low incidence. Noncontraceptive benefits include decreased menstrual blood loss, improved dysmenorrhea, improved pelvic pain associated with endometriosis, and protection of the endometrium from hyperplasia. The use of IUDs is accepted in patients with multiple medical problems who may have contraindications to other birth control methods. Yet despite well-published data, concerns and misperceptions still persist, especially among younger populations and nulliparous women. Medical governing bodies advocate for use of IUDs in these populations, as safety and efficacy is unchanged, and IUDs have been shown to decrease unintended pregnancies. Dispersion of accurate information among patients and practitioners is needed to further increase the acceptability and use of IUDs.

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The Impact of Out-of-Pocket Costs on the Use of Intrauterine Contraception Among Women With Employer-sponsored Insurance

Cited by 58 publications

References 30 publications

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision

Receipt of Prescription Contraception by Commercially Insured Women With Chronic Medical Conditions

Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States

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