Provision of Contraception in New York City School-Based Health Centers: Impact on Teenage Pregnancy and Avoided Costs, 2008-2017.

IF 3.4 2区医学 Q1 DEMOGRAPHY

Perspectives on Sexual and Reproductive Health Pub Date : 2019-12-01 DOI:10.1363/psrh.12126

Rebecca Fisher, Phoebe Danza, James McCarthy, Lorraine Tiezzi

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引用次数: 12

Abstract

Context: Since 2008, the School-Based Health Center Reproductive Health Project (SBHC RHP) has supported SBHCs in New York City (NYC) to increase the availability of effective contraception; however, its impact on teenage pregnancy and avoided costs has not been estimated.

Methods: The impact of the SBHC RHP on patterns of contraceptive use and on the numbers of pregnancies, abortions and births averted in 2008-2017 was estimated using program data and public data from the NYC Bureau of Vital Statistics and Youth Risk Behavior Survey. Data from the Guttmacher Institute on the cost of publicly funded births and abortions were used to estimate costs avoided; NYC-specific teenage pregnancy outcome data were employed to estimate the proportion of overall declines attributable to the SBHC RHP.

Results: Between 2008 and 2017, the SBHC RHP supported a substantial increase in the proportion of sexually active female clients using effective contraceptives. Most dramatically, 14% of clients in the SBHC RHP method mix used LARCs in 2017, compared with 2% in the non-SBHC RHP mix. The project averted an estimated 5,376 pregnancies, 2,104 births and 3,085 abortions, leading to an estimated $30,360,352 in avoided one-time costs of publicly funded births and abortions. These averted events accounted for 26-28% of the decline in teenage pregnancies, births and abortions in NYC.

Conclusions: When comprehensive reproductive health services are available in SBHCs, teenagers use them, resulting in substantially fewer pregnancies, abortions and births, and lower costs to public health systems.

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纽约市校本保健中心提供避孕措施:2008-2017年对少女怀孕和避免成本的影响

背景:自2008年以来，校本保健中心生殖健康项目(shbhc RHP)支持纽约市的shbhc，以增加有效避孕措施的可得性;然而，它对少女怀孕和避免成本的影响尚未得到估计。方法:利用项目数据和纽约市生命统计局和青少年风险行为调查的公共数据，估计shbhc RHP对2008-2017年避孕药具使用模式以及怀孕、堕胎和避免分娩数量的影响。古特马赫研究所(Guttmacher Institute)关于公共资助的分娩和堕胎成本的数据被用来估计避免的成本;采用纽约市特定的少女怀孕结局数据来估计可归因于shbhc RHP的总体下降比例。结果:2008年至2017年期间，shbhc RHP支持使用有效避孕药具的性活跃女性客户比例大幅增加。最引人注目的是，2017年，在shbhc RHP方法组合中，14%的客户使用larc，而在非shbhc RHP组合中，这一比例为2%。该项目估计避免了5,376次怀孕、2,104次分娩和3,085次堕胎，从而避免了约30,360 352美元的公共资助分娩和堕胎的一次性费用。这些被避免的事件占纽约市青少年怀孕、生育和堕胎率下降的26%至28%。结论:当shbhcs提供全面的生殖健康服务时，青少年会使用这些服务，从而大大减少怀孕、堕胎和分娩，并降低公共卫生系统的成本。

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

Perspectives on Sexual and Reproductive Health Multiple-

CiteScore

5.10

自引率

3.40%

发文量

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.