Farley Ordovensky Staniec J, Webb Natalie J
Department of Economics, University of the Pacific, Stockton, CA 95211, USA.
Health Serv Res. 2007 Jun;42(3 Pt 1):971-89. doi: 10.1111/j.1475-6773.2006.00640.x.
To estimate the effects of financial access and other individual characteristics on the likelihood that a woman pursues infertility treatment and the choice of treatment type.
DATA SOURCE/STUDY SETTING: The 1995 National Survey of Family Growth.
We use a binomial logit model to estimate the effects of financial access and individual characteristics on the likelihood that a woman pursues infertility treatment. We then use a multinomial logit model to estimate the differential effects of these variables across treatment types.
DATA COLLECTION/EXTRACTION METHOD: This study analyzes the subset of 1,210 women who meet the definition of infertile or subfecund from the 1995 National Survey of Family Growth.
We find that income, insurance coverage, age, and parity (number of previous births) all significantly affect the probability of seeking infertility treatment; however, the effect of these variables on choice of treatment type varies significantly. Neither income nor insurance influences the probability of seeking advice, a relatively low cost, low yield treatment. At the other end of the spectrum, the choice to pursue assisted reproductive technologies (ARTs)-a much more expensive but potentially more productive option-is highly influenced by income, but merely having private insurance has no significant effect. In the middle of the spectrum are treatment options such as testing, surgery, and medications, for which "financial access" increases their probability of selection.
Our results illustrate that for the sample of infertile of subfecund women of childbearing age studied, and considering their options, financial access to infertility treatment does matter.
评估经济可及性和其他个体特征对女性寻求不孕症治疗的可能性以及治疗类型选择的影响。
数据来源/研究背景：1995年全国家庭生育调查。
我们使用二项逻辑回归模型来评估经济可及性和个体特征对女性寻求不孕症治疗可能性的影响。然后，我们使用多项逻辑回归模型来评估这些变量在不同治疗类型之间的差异影响。
数据收集/提取方法：本研究分析了1995年全国家庭生育调查中符合不孕或生育力低下定义的1210名女性的子集。
我们发现收入、保险覆盖范围、年龄和胎次（既往生育次数）均显著影响寻求不孕症治疗的概率；然而，这些变量对治疗类型选择的影响差异显著。收入和保险都不会影响寻求咨询（一种成本相对较低、收益较低的治疗方式）的概率。在另一端，选择采用辅助生殖技术（ARTs，一种成本高得多但可能更有效的选择）受收入的影响很大，但仅有私人保险则没有显著影响。处于中间范围的是检测、手术和药物等治疗选择，“经济可及性”会增加选择这些治疗的概率。
我们的结果表明，对于所研究的育龄不孕或生育力低下女性样本，并考虑到她们的选择，获得不孕症治疗的经济可及性确实很重要。
