改善生育保护福利任务的实施
Sara B McMenamin1, Bonnie N Kaiser2, Ricardo E Flores Ortega3,4
1Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla.
JAMA health forum
|September 12, 2025
概括
国家对生育保护 (FP) 福利的授权面临诸如保险公司互动和患者知识差距等障碍. 专门的财务顾问和明确的福利定义使癌症患者更容易获得FP服务.
科学领域:
- 在瘤学瘤学.
- 生殖医学 生殖医学
- 卫生政策 卫生政策
背景情况:
- 每年有超过9万名青少年和年轻人接受癌症治疗,这些治疗可能会危及未来的生育能力.
- 生育保护 (FP) 服务 (卵子,胚胎,精子冷) 是至关重要的,但由于成本和获取问题,它们往往未得到充分利用.
- 尽管有18个州和华盛顿特区强制为FP提供保险,但患者和临床医生的准入仍然具有挑战性.
研究的目的:
- 系统地确定影响在生育和瘤诊所实施FP福利任务的决定因素.
- 为改善FP接入提供信息,为发展干预措施和未来的公共政策提供信息.
- 了解在临床和患者层面影响FP福利实施的障碍和促进因素.
主要方法:
- 这是一项混合方法研究,涉及来自24家瘤/生育诊所和3个不同州 (CA,IL,NY) 的2家生育药房的48名参与者.
- 采用了基于探索,准备,实施,维持 (EPIS) 框架的采访和调查.
- 数据收集时间为2020年7月至2023年11月,分析时间为2022年9月至2024年6月.
主要成果:
- 主要障碍包括耗时的诊所-保险公司互动,患者缺乏福利知识和保险覆盖不一致.
- 顶级促进者是专门的财务顾问来验证福利,在手册中明确定义FP福利,以及现有的试管婴儿保险.
- 采访 (n=48) 和调查 (n=17) 确定了成功实施FP福利任务的关键决定因素.
结论:
- 系统地识别障碍和促进者可以指导FP福利任务实施的改进.
- 调查结果支持政策和干预措施的制定,以提高患者和诊所及时获得FP保险福利的机会.
- 结果为未来的立法和监管努力提供了基础,旨在增加FP访问.
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