安大略省生育计划对重复生育咨询的影响。
The Impact of the Ontario Fertility Program on Duplicate Fertility Consultations.
作者信息
Assal Angela, Jones Claire Ann, Gotz Tamas, Shah Baiju R
机构信息
Endocrinologist, Division of Endocrinology and Metabolism, Sunnybrook Health Sciences Centre, Toronto, ON.
GREI Specialist, Department of Obstetrics and Gynaecology, Mount Sinai Fertility, Sinai Health System, Toronto, ON.
出版信息
Healthc Policy. 2019 May;14(4):66-77. doi: 10.12927/hcpol.2019.25855.
OBJECTIVES
The Ontario Fertility Program (OFP) funds 5,000 annual in vitro fertilization (IVF) cycles. We hypothesized that after introduction of the OFP, there would be an increase in duplicate infertility consultations by patients attempting to increase chances at obtaining publicly funded IVF through enlisting at multiple fertility clinics.
METHODS
This retrospective observational study included women eligible for healthcare services in Ontario from 2014 to 2016 and compared infertility consultations pre- and post-initiation of the OFP.
RESULTS
Post-OFP, the average number of consultations per patient and the proportion of patients with more than one consult increased (1.04 vs. 1.05, p = 0.015 and 3.8% vs. 4.2%, p = 0.027, respectively). Total consultations for infertility increased from 24,565 to 27,714 post-OFP. The OFP had the largest impact in the Greater Toronto Area (GTA).
CONCLUSION
The OFP resulted in a statistically significant increase in duplicate consultations, although unlikely to be of clinical relevance. The disproportionate impact seen in the GTA highlights the inequitable access to fertility care in Ontario.
目的
安大略省生育计划（OFP）每年为5000个体外受精（IVF）周期提供资金。我们假设，在OFP实施后，试图通过在多家生育诊所登记来增加获得公共资助IVF机会的患者进行重复不孕咨询的情况会有所增加。
方法
这项回顾性观察研究纳入了2014年至2016年在安大略省有资格获得医疗服务的女性，并比较了OFP启动前后的不孕咨询情况。
结果
OFP实施后，每位患者的平均咨询次数以及进行多次咨询的患者比例均有所增加（分别为1.04对1.05，p = 0.015；3.8%对4.2%，p = 0.027）。OFP实施后，不孕咨询的总数从24565次增加到27714次。OFP对大多伦多地区（GTA）的影响最大。
结论
OFP导致重复咨询在统计学上显著增加，尽管这可能与临床无关。在GTA看到的不成比例的影响凸显了安大略省生育护理获取的不平等。
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