Department of Health Science, College of Life Sciences, Brigham Young University, Provo, Utah 84602, USA.
Med Care. 2012 Jul;50(7):562-8. doi: 10.1097/MLR.0b013e318254331c.
Half of the states in the United States mandate that health insurers cover contraceptives. Health care reform includes recommendations to extend these mandates nationally through the essential benefits package. This study evaluates the association of state-level insurance mandates and consistent contraceptive use among privately insured women aged 15-44.
The National Survey of Family Growth (2006-2008) included 2276 privately insured women at risk for unintended pregnancy. Multilevel logistic regression models provided estimates of the association between state-level insurance coverage mandates and consistent contraceptive use.
Among privately insured women, 18% reported a ≥1-month gap in contraceptive use. Compared with women living in states with no mandates, those in states with comprehensive mandates had increased odds of consistent contraceptive use among privately insured women [adjusted odds ratio (aOR), 1.64; 95% confidence interval (CI), 1.08-2.50], but not uninsured women (aOR, 0.77; 95% CI, 0.38-1.55). Partial mandates were not associated with consistent contraceptive use.
Consistent contraceptive use among women with private insurance is higher in the states with mandates compared with those without mandates.
美国有一半的州要求健康保险公司为避孕药具提供保障。医疗改革建议通过基本福利套餐在全国范围内扩大这些授权。本研究评估了州级保险授权与私人保险的 15-44 岁有意外怀孕风险的女性持续使用避孕药具之间的关联。
全国家庭增长调查（2006-2008 年）包括 2276 名有意外怀孕风险的私人保险女性。多层次逻辑回归模型提供了州级保险覆盖授权与持续使用避孕药具之间关联的估计。
在私人保险的女性中，有 18%报告有≥1 个月的避孕药具使用空白期。与没有授权的州的女性相比，全面授权的州的女性持续使用避孕药具的几率更高[调整后的优势比（aOR），1.64；95%置信区间（CI），1.08-2.50]，但对没有保险的女性没有影响[aOR，0.77；95% CI，0.38-1.55]。部分授权与持续使用避孕药具无关。
与没有授权的州相比，有授权的州的女性持续使用避孕药具的比例更高。
