Cost Sharing and Utilization of Postpartum Intrauterine Devices and Contraceptive Implants Among Commercially Insured Women.
Womens Health Issues
; 29(6): 465-470, 2019.
Article
em En
| MEDLINE
| ID: mdl-31495642
ABSTRACT
BACKGROUND:
Cost sharing may impede postpartum contraceptive use. We evaluated the association between out-of-pocket costs and long-acting reversible contraceptive (LARC) insertion among commercially insured postpartum women.METHODS:
Using the Clinformatics Data Mart, we examined out-of-pocket costs for LARC insertions at 0 to 3 and 4-60 days postpartum among women in employer-sponsored health plans from 2013 to 2016. Patient costs were estimated by summing copayment, coinsurance, and deductible payments for LARC services (device + placement). Multivariable logistic regression evaluated the association between plan cost sharing for LARC services (at least one beneficiary with >$200 cost share) and LARC insertion by 60 days postpartum (yes/no).RESULTS:
We identified 396,073 deliveries among women in 51,797 employer-based plans. Overall, LARC placement by 60 days postpartum was observed after 5.2% (n = 20,604) of deliveries. Inpatient LARC insertion (n = 233; 0.06% of deliveries) was less common than outpatient LARC insertion (n = 20,375; 5.14% of deliveries). Cost sharing was observed in 23.4% of LARC insertions (inpatient IUD median, $50.00; range, $0.93-5,055.91; inpatient implant median, $11.91; range, $2.49-650.14; outpatient IUD median, $25.00; range, $0.01-3,354.80; outpatient implant median, $27.20; range, $0.18-2,444.01). Among 5,895 plans with at least one LARC insertion and after adjusting for patient age, poverty status, race/ethnicity, region, and plan type, women in plans with cost sharing of more than $200 demonstrated lower odds of LARC use by 60 days postpartum (odds ratio, 0.74; 95% confidence interval, 0.71-0.77).CONCLUSIONS:
Cost sharing for postpartum LARC is associated with use, suggesting that out-of-pocket costs may impede LARC access for some commercially insured postpartum women. Reducing out-of-pocket costs for the most effective forms of contraception may increase use.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Custo Compartilhado de Seguro
/
Comportamento Contraceptivo
/
Contracepção Reversível de Longo Prazo
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Seguro Saúde
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Dispositivos Intrauterinos
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article