Culwell Kelly R, Feinglass Joe
Program in Family Planning and Contraception, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Perspect Sex Reprod Health. 2007 Dec;39(4):226-30. doi: 10.1363/3922607.
Given that substantial proportions of women of reproductive age lack health insurance coverage, it is important to assess whether lack of insurance is associated with the use of prescription contraceptives, which are the most expensive but also the most effective methods for preventing pregnancy.
Data from 26,674 females aged 18-44 who participated in the 2002 Behavioral Risk Factor Surveillance System survey (representing more than 25 million women in the U.S. population) were used to assess risk of unintended pregnancy, prescription contraceptive use and health insurance status. Logistic regression models tested the likelihood of prescription contraceptive use among insured versus uninsured respondents after controlling for socioeconomic characteristics and self-reported overall health.
A significantly higher proportion of insured women than of uninsured women reported use of prescription contraceptives (54% vs. 45%). In multiple regression analysis, women lacking health insurance were 30% less likely to report using prescription contraceptive methods than were women with private or public health insurance. Results were similar across racial, age and income subgroups.
Lack of health insurance is associated with reduced use of prescription contraceptives. Universal insurance coverage is needed to ensure access to the most effective contraceptive methods for all women in need.
鉴于相当大比例的育龄妇女缺乏医疗保险覆盖，评估缺乏保险是否与处方避孕药的使用相关就显得很重要，因为处方避孕药是预防怀孕最昂贵但也是最有效的方法。
来自26674名年龄在18 - 44岁之间参与2002年行为危险因素监测系统调查的女性的数据（代表美国人口中超过2500万女性）被用于评估意外怀孕风险、处方避孕药使用情况和医疗保险状况。逻辑回归模型在控制社会经济特征和自我报告的总体健康状况后，测试了参保与未参保受访者使用处方避孕药的可能性。
报告使用处方避孕药的参保女性比例显著高于未参保女性（54%对45%）。在多元回归分析中，缺乏医疗保险的女性报告使用处方避孕方法的可能性比拥有私人或公共医疗保险的女性低30%。在不同种族、年龄和收入亚组中结果相似。
缺乏医疗保险与处方避孕药使用减少相关。需要全民保险覆盖以确保所有有需要的女性都能获得最有效的避孕方法。
