Guttmacher Institute, New York, NY, USA.
Guttmacher Institute, New York, NY, USA.
Contraception. 2024 Dec;140:110553. doi: 10.1016/j.contraception.2024.110553. Epub 2024 Jul 30.
This study aimed to examine the characteristics of foreign-born abortion patients compared to those born in the Unites States and to explore whether barriers for foreign-born patients varied by state Medicaid coverage of abortion care.
We used data from the Guttmacher Institute's 2021-2022 Abortion Patient Survey, a national sample of patients obtaining clinic-based abortion care in the United States. We compared sociodemographic characteristics of foreign- and US born respondents, as well as barriers to care. Among foreign-born patients, we compared those in Medicaid coverage states vs states that restrict Medicaid coverage.
Some 12% of the 6429 respondents were born outside the United States. Compared to US born patients, they were less likely to have Medicaid coverage and more likely to be Asian/Native Hawaiian/Pacific Islander or Hispanic, to have no health insurance, and to have completed the survey in Spanish. In addition, foreign-born patients were more likely to report delays because they did not know where to get an abortion (18.3% vs. 12.6% for US born). Compared to foreign-born patients living in Medicaid coverage states, those in non-Medicaid states reported multiple barriers, particularly related to cost: respondents in non-Medicaid states were three times as likely to pay out of pocket for abortion (75.8% vs 27.4%) and five times more likely to rely on financial assistance (24.1% vs 4.8%).
Foreign-born abortion patients face knowledge and financial barriers to accessing abortion care compared to those who are US born, and these financial burdens are amplified for those living in non-Medicaid coverage states.
Abortion patients born outside the United States may have overcome many obstacles to obtain care. Expanding state Medicaid coverage of abortion could reduce cost burdens for foreign-born populations.
本研究旨在比较外国出生的堕胎患者与美国本土出生的堕胎患者的特点，并探讨外国出生患者的堕胎障碍是否因各州对堕胎护理的医疗补助覆盖范围而异。
我们使用了盖特马赫研究所（Guttmacher Institute）2021-2022 年堕胎患者调查的数据，这是一项在美国获得诊所堕胎护理的患者的全国性样本。我们比较了外国出生和美国本土出生的受访者的社会人口统计学特征，以及他们面临的障碍。在外国出生的患者中，我们比较了那些在医疗补助覆盖州和限制医疗补助覆盖州的患者。
在 6429 名受访者中，约有 12%的人出生在美国以外的国家。与美国本土出生的患者相比，他们更有可能没有医疗保险，更有可能是亚裔/美国原住民/太平洋岛民或西班牙裔，也更有可能在调查中使用西班牙语，并且更有可能因不知道在哪里可以获得堕胎而延迟（18.3% vs. 12.6%）。与居住在医疗补助覆盖州的外国出生患者相比，居住在非医疗补助州的患者报告了多种障碍，尤其是与费用有关的障碍：非医疗补助州的患者中，有 75.8%的人自掏腰包支付堕胎费用，而只有 27.4%的人自掏腰包支付堕胎费用，自掏腰包支付堕胎费用的可能性是美国本土出生患者的三倍；有 24.1%的人依赖经济援助，而只有 4.8%的人依赖经济援助，自掏腰包支付堕胎费用的可能性是美国本土出生患者的五倍。
与美国本土出生的堕胎患者相比，外国出生的堕胎患者在获得堕胎护理方面面临着知识和经济方面的障碍，而对于居住在非医疗补助覆盖州的患者来说，这些经济负担更加沉重。
出生在美国以外的堕胎患者可能已经克服了许多障碍来获得医疗服务。扩大州医疗补助对堕胎的覆盖范围可以减轻外国出生人群的经济负担。
