Pricing of medication abortion in the United States, 2021-2023.

IF 3.4 2区 医学 Q1 DEMOGRAPHY
Ushma D Upadhyay, Rosalyn Schroeder, Shelly Kaller, Clara Stewart, Nancy F Berglas
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Abstract

Introduction: Financial costs remain one of the greatest barriers to abortion, leading to delays in care and preventing some from getting a desired abortion. Medication abortion is available through in-person facilities and telehealth services. However, whether telehealth offers a more affordable option has not been well-documented.

Methods: We used Advancing New Standards in Reproductive Health (ANSIRH)'s Abortion Facility Database, which includes data on all publicly advertising abortion facilities and is updated annually. We describe facility out-of-pocket prices for medication abortion in 2021, 2022, and 2023, comparing in-person and telehealth provided by brick-and-mortar and virtual clinics, and by whether states allowed Medicaid coverage for abortion.

Results: The national median price for medication abortion remained consistent at $568 in 2021 and $563 in 2023. However, medications provided by virtual clinics were notably lower in price than in-person care and this difference widened over time. The median cost of a medication abortion offered in-person increased from $580 in 2021 to $600 by 2023, while the median price of a medication abortion offered by virtual clinics decreased from $239 in 2021 to $150 in 2023. Among virtual clinics, few (7%) accepted Medicaid. Median prices in states that accept Medicaid were generally higher than in states that did not.

Discussion: Medication abortion is offered at substantially lower prices by virtual clinics. However, not being able to use Medicaid or other insurance may make telehealth cost-prohibitive for some people, even if prices are lower. Additionally, many states do not allow telehealth for abortion, deepening inequities in healthcare.

2021-2023 年美国药物流产的定价。
导言:经济成本仍然是人工流产的最大障碍之一,导致护理工作的延误,使一些人无法获得想要的人工流产。药物流产可通过现场设施和远程保健服务进行。然而,远程医疗是否提供了一种更经济实惠的选择尚未得到充分证实:我们使用了推进生殖健康新标准(ANSIRH)的人工流产机构数据库,其中包括所有公开宣传的人工流产机构的数据,并每年更新。我们描述了 2021 年、2022 年和 2023 年药物流产的机构自付价格,比较了实体诊所和虚拟诊所提供的面对面服务和远程医疗服务,以及各州是否允许将流产纳入医疗补助范围:结果:全国药物流产的中位数价格在 2021 年和 2023 年保持一致,分别为 568 美元和 563 美元。然而,虚拟诊所提供的药物流产价格明显低于现场护理,而且这种差异随着时间的推移而扩大。面对面提供的药物流产费用中位数从 2021 年的 580 美元增至 2023 年的 600 美元,而虚拟诊所提供的药物流产费用中位数从 2021 年的 239 美元降至 2023 年的 150 美元。在虚拟诊所中,接受医疗补助的诊所很少(7%)。接受医疗补助的州的中位数价格普遍高于不接受医疗补助的州:讨论:虚拟诊所提供的药物流产价格要低得多。然而,无法使用医疗补助计划或其他保险可能会使一些人无法承受远程医疗的费用,即使价格较低。此外,许多州不允许远程医疗堕胎,这加深了医疗保健中的不平等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
24
期刊介绍: Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.
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