在年轻人中普遍提供药物护理和避孕药
Amanda K Downey1, Steven E Hanna1, Mitchell A Levine1,2,3
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
JAMA pediatrics
|August 18, 2025
概括
消除对避孕的经济障碍增加了安大略省年轻人使用IUD和OCP的数量. 处方避孕药 (OHIP+) 的公共资金导致了更高的处方率,特别是在较低的社会经济领域.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 生殖健康 生殖健康
背景情况:
- 经济障碍可能会阻碍获得避孕措施,可能会增加意外怀孕.
- 以前的研究表明,降低成本的策略可能会提高避孕药的使用率.
研究的目的:
- 评估对安大略省年轻女性处方避孕药的普遍公共资金 (OHIP+) 和随后的计划修正 (OHIP-) 对避孕药发放的影响.
- 评估政策实施后,宫内器械 (IUD) 和口服避孕药 (OCP) 发行率的变化.
主要方法:
- 使用2016年9月至2020年2月的零售药房分发的国家数据库进行了中断时间序列分析.
- 干预组包括15-24岁的安大略省女性;对照组包括15-24岁的加拿大女性 (不包括安大略省) 和25-49岁的安大略省女性.
- 对IUD和OCP的发行数据进行了整体分析,并按区域级社会经济地位 (SES) 分析.
主要成果:
- 在OHIP+之后,与国家对照相比,在15-24岁的安大略省女性中,IUD和OCP发放量显著增加.
- 在较低的SES地区,OHIP+与IUD和OCP发放量显著增加有关,而OHIP-与IUD发放量减少有关.
- 在高SES地区的OHIP+或OHIP-之后,没有观察到分配趋势的重大变化,也没有观察到整体月度趋势的重大变化.
结论:
- 通过公共资金提供对处方避孕药的全面和机密访问,与年轻人使用避孕药的增加有关.
- 旨在降低避孕的财政障碍的政策干预可以积极影响分发模式,特别是长效可逆避孕药 (LARC) 和口服避孕药.
- 这些发现强调了公平获得避孕措施的重要性,在较低的社会经济阶层中观察到显著的影响.
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