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Integrated Healthcare System01:20

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An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
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Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
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Do state insurance mandates alter ICSI utilization?

Pavel Zagadailov1, David B Seifer2, He Shan3,4

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Reproductive Biology and Endocrinology : RB&E
|April 27, 2020
PubMed
Summary
This summary is machine-generated.

Assisted reproductive technology (ART) insurance mandates were associated with lower intracytoplasmic sperm injection (ICSI) use but higher success rates. Mandated states showed greater elective single-embryo transfer (eSET) and fewer twin births, suggesting more selective lab resource use.

Keywords:
Assisted reproductive technologyIn-vitro fertilizationInsurance mandatesIntracytoplasmic sperm injection

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Area of Science:

  • Reproductive Medicine
  • Health Services Research
  • Public Health Policy

Background:

  • Assisted reproductive technology (ART) insurance mandates have improved access to infertility treatments.
  • Intracytoplasmic sperm injection (ICSI) is a key ART procedure.
  • The association between ART insurance mandates and ICSI utilization requires examination.

Purpose of the Study:

  • To investigate the relationship between state-level ART insurance mandates and the utilization of ICSI.
  • To compare ICSI use, infertility factors, and outcomes in states with and without ART insurance mandates.

Main Methods:

  • Retrospective cohort study using 2000-2016 CDC data.
  • Comparison of ICSI use and male factor (MF) infertility in mandated (n=8) versus non-mandated (n=22) states for fresh, non-donor ART cycles in women <35 years.
  • Analysis of clinical pregnancy (CPR), live birth (LBR), preimplantation genetic testing (PGT), elective single-embryo transfer (eSET), and twin birth rates using Welch's t-test and Pearson correlation.

Main Results:

  • ICSI use increased in both mandated and non-mandated states from 2000-2016.
  • Non-mandated states showed significantly higher ICSI use from 2011-2016.
  • Mandated states had lower MF rates, CPR, and LBR, but higher eSET and lower twin birth rates compared to non-mandated states.

Conclusions:

  • Greater ICSI use in non-mandated states correlated with increased male factor infertility.
  • In mandated states, lower ICSI rates correlated positively with CPR and LBR.
  • ART insurance mandates may promote more selective use of laboratory resources, potentially improving outcomes and reducing multiple births.