Monash University, Melbourne, VIC.
The University of Sydney, Sydney, NSW.
Med J Aust. 2021 Oct 18;215(8):366-370. doi: 10.5694/mja2.51275. Epub 2021 Sep 22.
To examine primary care provision of early medical abortion services in Australia.
Cross-sectional study; analysis of Pharmaceutical Benefits Scheme (PBS) dispensing data.
SETTING, PARTICIPANTS: Women of child-bearing age (15-54 years), Australia, 2015-2019.
Age-standardised rates of MS-2 Step prescriptions dispensed by year for 2015-2019, and age-standardised rates by state, remoteness area, and level 3 statistical areas (SA3s) for 2019. Numbers and proportions of SA3s in which MS-2 Step was not prescribed by a GP or dispensed by a community pharmacy during 2019 (unweighted and weighted by number of women of reproductive age), by state and remoteness area.
During 2015-2019, 91 643 PBS prescriptions for MS-2 Step were dispensed; the national age-standardised rate increased from 1.63 in 2015 to 3.79 prescriptions per 1000 women aged 15-54 years in 2019. In 2019, rates were higher in outer regional Australia (6.53 prescriptions per 1000 women aged 15-54 years) and remote Australia (6.02 per 1000) than in major cities (3.30 per 1000). However, about 30% of women in Australia lived in SA3s in which MS-2 Step had not been prescribed by a GP during 2019, including about 50% of those in remote Australia.
The rate of early medical abortion is greater among women in remote, outer regional, and inner regional Australia than in major cities, but a considerable proportion of women live in areas in which MS-2 Step was not locally prescribed or dispensed during 2019. Supporting GPs in the delivery of early medical abortion services locally should be a focus of health policy.
考察澳大利亚初级医疗保健提供早期药物流产服务的情况。
横断面研究;对药品福利计划(PBS)配药数据进行分析。
地点、参与者:育龄妇女(15-54 岁),澳大利亚,2015-2019 年。
2015-2019 年每年 MS-2 步处方的年龄标准化配药率,以及 2019 年各州、偏远地区和 3 级统计区(SA3)的年龄标准化配药率。2019 年未由全科医生开具或由社区药房配药的 MS-2 步处方的 SA3 数量和比例(未加权和按育龄妇女人数加权),按州和偏远地区划分。
2015-2019 年期间,PBS 共配药 91643 份 MS-2 步处方;全国年龄标准化率从 2015 年的 1.63 上升到 2019 年每 1000 名 15-54 岁育龄妇女 3.79 份。2019 年,外区域澳大利亚(每 1000 名 15-54 岁育龄妇女 6.53 份)和偏远地区(每 1000 名 6.02 份)的配药率高于主要城市(每 1000 名 3.30 份)。然而,大约 30%的澳大利亚妇女居住在 2019 年没有由全科医生开具 MS-2 步处方的 SA3 区,其中包括大约 50%的偏远地区妇女。
与主要城市相比,偏远、外区域和内区域澳大利亚的妇女早期药物流产率更高,但在 2019 年,相当一部分妇女居住在没有当地开具或配药 MS-2 步的地区。支持全科医生在当地提供早期药物流产服务应成为卫生政策的重点。