三个州的州医疗补助计划(Medicaid)对堕胎患者的影响。

IF 3.4 2区 医学 Q1 DEMOGRAPHY
Susan K R Heil, Koray Caglayan, Graciela Castillo, Cristian Valenzuela-Mendez, Coretta Mallery Lankford, Gina Sgro, Manxi Yang, Lori Downing, Meera Bhalla, Stephanie McNally Davis
{"title":"三个州的州医疗补助计划(Medicaid)对堕胎患者的影响。","authors":"Susan K R Heil, Koray Caglayan, Graciela Castillo, Cristian Valenzuela-Mendez, Coretta Mallery Lankford, Gina Sgro, Manxi Yang, Lori Downing, Meera Bhalla, Stephanie McNally Davis","doi":"10.1111/psrh.12275","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Medicaid is a major funder of reproductive health services, including family planning and pregnancy-related care, especially for people with limited income and people of color. Federal Medicaid funds cannot be used for abortion however 16 states allow state Medicaid funds to pay for abortion. In recent years, Illinois and Maine implemented, and West Virginia discontinued, state Medicaid coverage of abortion.</p><p><strong>Methodology: </strong>With retrospective procedure- and patient-level data obtained from clinics in these three states, we used an interrupted time series design, multivariable regression models, and descriptive statistics to assess changes in procedure volume and patients' share of total procedure price (patient price).</p><p><strong>Results: </strong>In Maine and Illinois, implementing state Medicaid coverage of abortion contributed to an immediate overall increase in abortion access (as seen by a rise in monthly procedure volume at the time of the policy's implementation), a decrease in patient price (by 36% in Maine and 44% in Illinois) after policy implementation as compared to pre-implementation, and overall improved access among people of color. Conversely, when West Virginia discontinued coverage, access to care decreased, patient price increased by 130%, and the share of abortion procedures among people of color decreased.</p><p><strong>Conclusions: </strong>In the fragmented abortion access landscape of the post-Roe era, our study provides new evidence that financial assistance offered through state Medicaid policies that cover abortion may be most helpful to those facing traditional structural inequities to access, while discontinuation of Medicaid coverage of abortion further burdens those already economically marginalized.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of state Medicaid coverage of abortion on people accessing care in three states.\",\"authors\":\"Susan K R Heil, Koray Caglayan, Graciela Castillo, Cristian Valenzuela-Mendez, Coretta Mallery Lankford, Gina Sgro, Manxi Yang, Lori Downing, Meera Bhalla, Stephanie McNally Davis\",\"doi\":\"10.1111/psrh.12275\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>Medicaid is a major funder of reproductive health services, including family planning and pregnancy-related care, especially for people with limited income and people of color. Federal Medicaid funds cannot be used for abortion however 16 states allow state Medicaid funds to pay for abortion. In recent years, Illinois and Maine implemented, and West Virginia discontinued, state Medicaid coverage of abortion.</p><p><strong>Methodology: </strong>With retrospective procedure- and patient-level data obtained from clinics in these three states, we used an interrupted time series design, multivariable regression models, and descriptive statistics to assess changes in procedure volume and patients' share of total procedure price (patient price).</p><p><strong>Results: </strong>In Maine and Illinois, implementing state Medicaid coverage of abortion contributed to an immediate overall increase in abortion access (as seen by a rise in monthly procedure volume at the time of the policy's implementation), a decrease in patient price (by 36% in Maine and 44% in Illinois) after policy implementation as compared to pre-implementation, and overall improved access among people of color. Conversely, when West Virginia discontinued coverage, access to care decreased, patient price increased by 130%, and the share of abortion procedures among people of color decreased.</p><p><strong>Conclusions: </strong>In the fragmented abortion access landscape of the post-Roe era, our study provides new evidence that financial assistance offered through state Medicaid policies that cover abortion may be most helpful to those facing traditional structural inequities to access, while discontinuation of Medicaid coverage of abortion further burdens those already economically marginalized.</p>\",\"PeriodicalId\":47632,\"journal\":{\"name\":\"Perspectives on Sexual and Reproductive Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Perspectives on Sexual and Reproductive Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/psrh.12275\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DEMOGRAPHY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perspectives on Sexual and Reproductive Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/psrh.12275","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DEMOGRAPHY","Score":null,"Total":0}
引用次数: 0

摘要

背景:医疗补助计划 "是生殖健康服务(包括计划生育和妊娠相关护理)的主要资助者,尤其是针对收入有限的人群和有色人种。联邦医疗补助基金不能用于堕胎,但 16 个州允许州医疗补助基金支付堕胎费用。近年来,伊利诺伊州和缅因州实施了州医疗补助计划,而西弗吉尼亚州则停止了州医疗补助计划对堕胎的支付:我们利用从这三个州的诊所获得的手术和患者层面的回顾性数据,采用间断时间序列设计、多变量回归模型和描述性统计来评估手术量和患者在手术总价格(患者价格)中所占份额的变化:在缅因州和伊利诺伊州,实施州医疗补助堕胎保险有助于立即全面提高堕胎的可及性(表现为政策实施时每月手术量的上升),政策实施后患者价格较实施前下降(缅因州下降 36%,伊利诺伊州下降 44%),有色人种的可及性得到全面提高。相反,当西弗吉尼亚州停止承保时,获得医疗服务的机会减少了,患者价格上涨了 130%,有色人种接受堕胎手术的比例下降了:我们的研究提供了新的证据,表明在后罗伊时代,通过州医疗补助(Medicaid)政策提供的涵盖堕胎的财政援助可能对那些面临传统结构性不平等的人群最有帮助,而终止医疗补助(Medicaid)对堕胎的覆盖则进一步加重了那些已经在经济上被边缘化的人群的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of state Medicaid coverage of abortion on people accessing care in three states.

Context: Medicaid is a major funder of reproductive health services, including family planning and pregnancy-related care, especially for people with limited income and people of color. Federal Medicaid funds cannot be used for abortion however 16 states allow state Medicaid funds to pay for abortion. In recent years, Illinois and Maine implemented, and West Virginia discontinued, state Medicaid coverage of abortion.

Methodology: With retrospective procedure- and patient-level data obtained from clinics in these three states, we used an interrupted time series design, multivariable regression models, and descriptive statistics to assess changes in procedure volume and patients' share of total procedure price (patient price).

Results: In Maine and Illinois, implementing state Medicaid coverage of abortion contributed to an immediate overall increase in abortion access (as seen by a rise in monthly procedure volume at the time of the policy's implementation), a decrease in patient price (by 36% in Maine and 44% in Illinois) after policy implementation as compared to pre-implementation, and overall improved access among people of color. Conversely, when West Virginia discontinued coverage, access to care decreased, patient price increased by 130%, and the share of abortion procedures among people of color decreased.

Conclusions: In the fragmented abortion access landscape of the post-Roe era, our study provides new evidence that financial assistance offered through state Medicaid policies that cover abortion may be most helpful to those facing traditional structural inequities to access, while discontinuation of Medicaid coverage of abortion further burdens those already economically marginalized.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信