Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama.
Womens Health Issues. 2017 Sep-Oct;27(5):523-529. doi: 10.1016/j.whi.2017.04.002. Epub 2017 May 12.
In 2013, Alabama required women seeking abortion to have a consultation visit followed by a 24-hour waiting period. These requirements may adversely affect return for timely care among those traveling long distances for services.
Using de-identified billing data from two Alabama clinics for all abortion encounters in 2013, we calculated the distance traveled from women's residential zip code and the number of days between their in-person consultation and procedure visits. To assess the associations between distance traveled and return for an abortion visit and length of interval between visits, we used logistic and ordinal logistic regression, respectively.
Of the 2,730 women attending a consultation visit, 58% traveled less than 25 miles one way to the clinic, 13% traveled 25 to 49 miles, 21% traveled 50 to 100 miles, and 8% traveled more than 100 miles. Overall, 19% of women did not return to either clinic for an abortion procedure after their consultation. Distance traveled was not associated with return for an abortion visit (odds ratio, 1.04; 95% confidence interval, 0.76-1.42). Among women who returned, 59% had less than 7 days, 29% had 7 to 13 days, and 12% had 14 or more days between their consultation and procedure visits. Compared with women traveling less than 25 miles, those traveling 50 to 100 miles had significantly longer intervals between visits (odds ratio, 1.25; 95% confidence interval, 1.01-1.56).
Although most women returned for their abortion procedure, many traveling long distances had a week or more between visits. Because delays may limit women's options for affordable abortion care, evidence-based policies should be adopted to facilitate women's timely receipt of services.
2013 年，阿拉巴马州要求寻求堕胎的女性进行咨询访问，并等待 24 小时。这些要求可能会对那些长途旅行寻求服务的人及时获得护理产生不利影响。
我们使用 2013 年两家阿拉巴马州诊所的匿名计费数据，计算了每位女性从居住地邮政编码到诊所的旅行距离，以及其亲自咨询与手术访问之间的天数。为了评估旅行距离与堕胎就诊返回率和就诊间隔时间之间的关联，我们分别使用逻辑回归和有序逻辑回归。
在 2730 名接受咨询访问的女性中，58%的人前往诊所的单程旅行距离不到 25 英里，13%的人旅行距离为 25 至 49 英里，21%的人旅行距离为 50 至 100 英里，8%的人旅行距离超过 100 英里。总体而言，19%的女性在咨询后没有返回任何一家诊所进行堕胎手术。旅行距离与堕胎就诊返回率无关（优势比，1.04；95%置信区间，0.76-1.42）。在返回的女性中，59%的人两次就诊的间隔时间不到 7 天，29%的人间隔时间为 7 至 13 天，12%的人间隔时间为 14 天或更长。与旅行距离不足 25 英里的女性相比，旅行距离为 50 至 100 英里的女性两次就诊的间隔时间明显更长（优势比，1.25；95%置信区间，1.01-1.56）。
尽管大多数女性返回诊所进行堕胎手术，但许多长途旅行的女性两次就诊的间隔时间超过一周。由于延迟可能限制女性获得负担得起的堕胎护理的选择，因此应采取基于证据的政策，以促进女性及时获得服务。
