在全州范围的倡议之后,产后长效可逆避孕药的采用
Katie Gifford1, Rebecca McColl1, Mary Joan McDuffie1
1Biden School of Public Policy & Administration, University of Delaware, Newark, Delaware, USA.
Health services research
|March 16, 2024
概括
德拉华州的一项干预措施促进了医疗补助患者的产后长效可逆避孕药 (LARC) 使用. 产后LARC插入增加了,显示了该计划.
科学领域:
- 公共卫生 公共卫生
- 生殖健康 生殖健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 产后期是开始避孕的关键时间.
- 医疗补助患者在获得产后避孕措施方面面临着独特的障碍.
- 获得避孕措施的干预措施旨在改善生殖健康结果.
研究的目的:
- 评估德拉华州 (2015-2020年) 全州范围内的干预措施,以改善分娩后医疗补助患者获得避孕措施的机会.
- 评估对所有避孕方法的启动的影响,重点是长效可逆避孕药 (LARC).
- 检查针对分娩后及门诊环境的干预措施.
主要方法:
- 利用了来自特拉华州和马里兰州的医疗补助索赔数据 (比较州) 从2012年至2019年.
- 采用差异差异方法来分析避孕方法使用的变化,直到分娩后60天.
- 评估LARC插入在分娩后立即和60天后,以及其他方法.
主要成果:
- 这项干预显著增加了产后LARC插入,在早期采用医院的LARC插入量增加了11.7个百分点,在后来采用医院的LARC插入量增加了6.9个百分点.
- 产后LARC的增加是主要的驱动因素,没有证据表明会取代门诊LARC服务.
- 观察到从短效方法替代LARC,在早期采用医院的避孕方法使用总体增加.
结论:
- 直接偿还产后LARC费用,加上提供者培训,有效地增加了Medicaid产后妇女的LARC使用率.
- 该干预措施对产后期的避孕方法的使用产生了重大影响.
- 针对产后患者的有针对性的干预措施可以改善医疗补助人口中的避孕措施的获取和使用.
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