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医疗补助计划生育扩展:州计划修正案对产后避孕措施使用的影响。

Medicaid Family Planning Expansions: The Effect of State Plan Amendments on Postpartum Contraceptive Use.

机构信息

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

出版信息

J Womens Health (Larchmt). 2019 Apr;28(4):551-559. doi: 10.1089/jwh.2018.7129. Epub 2018 Nov 28.

Abstract

OBJECTIVE

To determine the effect of state Medicaid family planning (FP) programs transitioning from a Section 1115 waiver to a State Plan Amendment (SPA) on reproductive health outcomes.

MATERIALS AND METHODS

Data were from the Pregnancy Risk Assessment Monitoring System on 75,082 women who had a live birth between 2007 and 2013 and were living in one of nine states. We performed a difference-in-differences analysis to quantify the effect of the transition on postpartum contraceptive (PPC) use and unintended births (UBs).

RESULTS

Over 80% of the sample reported using PPC; half reported an UB. The odds of PPC use among women who were living in a study state and gave birth after the transition were 1.14 times that of women who were living in a comparison state and/or gave birth before the transition (95% confidence interval: 1.04-1.24).

CONCLUSIONS

Findings suggest that women living in states that transitioned from a waiver to SPA experienced an increased likelihood of PPC compared with those living in comparison states.

摘要

目的

确定州医疗补助计划生育(FP)计划从第 1115 项豁免过渡到州计划修正案(SPA)对生殖健康结果的影响。

材料和方法

数据来自 2007 年至 2013 年间生活在 9 个州之一的 75082 名活产妇女的妊娠风险评估监测系统。我们进行了差异分析,以量化过渡对产后避孕药具(PPC)使用和意外怀孕(UB)的影响。

结果

超过 80%的样本报告使用了 PPC;一半报告了 UB。与生活在比较州且在过渡前分娩的妇女相比,生活在研究州且在过渡后分娩的妇女使用 PPC 的几率高 1.14 倍(95%置信区间:1.04-1.24)。

结论

研究结果表明,与生活在比较州的妇女相比,从豁免过渡到 SPA 的州的妇女更有可能使用 PPC。

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