Erica L. Eliason PhD , Marie E. Thoma PhD , Maria W. Steenland SD
{"title":"美国医疗补助和私人医疗保险人群使用生育治疗的差异","authors":"Erica L. Eliason PhD , Marie E. Thoma PhD , Maria W. Steenland SD","doi":"10.1016/j.whi.2023.03.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>We aimed to compare differences in receipt of any and specific types of fertility services between people with Medicaid and private insurance.</p></div><div><h3>Methods</h3><p>We used National Survey of Family Growth (2002–2019) data and linear probability regression models to examine the association between insurance type (Medicaid or private) and fertility service use. The primary outcome was use of fertility services in the past 12 months, and secondary outcomes were use of specific types of fertility services at any time: 1) testing, 2) common medical treatment, and 3) use of any fertility treatment type (testing, medical treatment, or surgical treatment of infertility). We additionally calculated time-to-pregnancy using a method that estimates the unobserved total amount of time the respondent spent trying to become pregnant using their current duration of pregnancy attempt at the time of the survey. We calculated time-to-pregnancy ratios across respondent characteristics to examine if insurance type was associated with differential time-to-pregnancy.</p></div><div><h3>Results</h3><p>In adjusted models, Medicaid coverage was associated with an 11.2-percentage point (95% confidence interval: −22.3 to −0.0) lower use of fertility services in the past 12 months compared with private coverage. Relative to private coverage, Medicaid insurance was also associated with large and statistically significantly lower rates of ever having used infertility testing or any fertility services. Insurance type was not associated with differences in time-to-pregnancy.</p></div><div><h3>Conclusions</h3><p>People covered by Medicaid were less likely to have used fertility services compared with people with private insurance. Differences in coverage of fertility services between Medicaid and private payers may represent a barrier to fertility treatment for Medicaid recipients.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10330011/pdf/","citationCount":"1","resultStr":"{\"title\":\"Differences in Use of Fertility Treatment Between People With Medicaid and Private Health Insurance Coverage in the United States\",\"authors\":\"Erica L. Eliason PhD , Marie E. Thoma PhD , Maria W. Steenland SD\",\"doi\":\"10.1016/j.whi.2023.03.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>We aimed to compare differences in receipt of any and specific types of fertility services between people with Medicaid and private insurance.</p></div><div><h3>Methods</h3><p>We used National Survey of Family Growth (2002–2019) data and linear probability regression models to examine the association between insurance type (Medicaid or private) and fertility service use. The primary outcome was use of fertility services in the past 12 months, and secondary outcomes were use of specific types of fertility services at any time: 1) testing, 2) common medical treatment, and 3) use of any fertility treatment type (testing, medical treatment, or surgical treatment of infertility). We additionally calculated time-to-pregnancy using a method that estimates the unobserved total amount of time the respondent spent trying to become pregnant using their current duration of pregnancy attempt at the time of the survey. We calculated time-to-pregnancy ratios across respondent characteristics to examine if insurance type was associated with differential time-to-pregnancy.</p></div><div><h3>Results</h3><p>In adjusted models, Medicaid coverage was associated with an 11.2-percentage point (95% confidence interval: −22.3 to −0.0) lower use of fertility services in the past 12 months compared with private coverage. Relative to private coverage, Medicaid insurance was also associated with large and statistically significantly lower rates of ever having used infertility testing or any fertility services. Insurance type was not associated with differences in time-to-pregnancy.</p></div><div><h3>Conclusions</h3><p>People covered by Medicaid were less likely to have used fertility services compared with people with private insurance. Differences in coverage of fertility services between Medicaid and private payers may represent a barrier to fertility treatment for Medicaid recipients.</p></div>\",\"PeriodicalId\":48039,\"journal\":{\"name\":\"Womens Health Issues\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10330011/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Womens Health Issues\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1049386723000713\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Womens Health Issues","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1049386723000713","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Differences in Use of Fertility Treatment Between People With Medicaid and Private Health Insurance Coverage in the United States
Objectives
We aimed to compare differences in receipt of any and specific types of fertility services between people with Medicaid and private insurance.
Methods
We used National Survey of Family Growth (2002–2019) data and linear probability regression models to examine the association between insurance type (Medicaid or private) and fertility service use. The primary outcome was use of fertility services in the past 12 months, and secondary outcomes were use of specific types of fertility services at any time: 1) testing, 2) common medical treatment, and 3) use of any fertility treatment type (testing, medical treatment, or surgical treatment of infertility). We additionally calculated time-to-pregnancy using a method that estimates the unobserved total amount of time the respondent spent trying to become pregnant using their current duration of pregnancy attempt at the time of the survey. We calculated time-to-pregnancy ratios across respondent characteristics to examine if insurance type was associated with differential time-to-pregnancy.
Results
In adjusted models, Medicaid coverage was associated with an 11.2-percentage point (95% confidence interval: −22.3 to −0.0) lower use of fertility services in the past 12 months compared with private coverage. Relative to private coverage, Medicaid insurance was also associated with large and statistically significantly lower rates of ever having used infertility testing or any fertility services. Insurance type was not associated with differences in time-to-pregnancy.
Conclusions
People covered by Medicaid were less likely to have used fertility services compared with people with private insurance. Differences in coverage of fertility services between Medicaid and private payers may represent a barrier to fertility treatment for Medicaid recipients.
期刊介绍:
Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.