Estimating the Fertility Effect of Expansions of Publicly Funded Family Planning Services in California
ABSTRACT To estimate the number of unintended pregnancies averted through the provision of family planning services to low income women in Family PACT, California's Medicaid waiver program.
We use a Markov model to estimate the number of pregnancies in the absence of Family PACT based on the contraceptive method mix used before program enrollment, and pregnancies in the presence of the program, based on method dispensing claims.
Nearly 1 million (998,084) women were provided with contraceptives in Family PACT in 2007. Contraceptive services averted over an estimated 286,700 unintended pregnancies including 122,000 abortions, 133,000 unintended births, and over 40,000 births among teens.
This conservative measure of the effect of Family PACT on unintended pregnancies indicates the benefit of expanding access to contraceptive services, an example for other states considering expanding access to family planning services through a state plan amendment under health care reform.
SourceAvailable from: Maria Isabel Rodriguez[Show abstract] [Hide abstract]
ABSTRACT: In this era of healthcare reform, attention is focused on increasing the quality of care and access to services, while simultaneously reducing the cost. Economic evaluations can play an important role in translating research to evidence-based practice and policy. Cost-effectiveness analysis (CEA) and its utility for clinical and policy decision making among U.S. obstetricians and gynecologists is reviewed. Three case examples demonstrating the value of this methodology in decision making are considered. A discussion of the methodologic principles of CEA, the advantages, and the limitations of the methodology are presented. CEA can play an important role in evidence-based decision making, with value for clinicians and policy makers alike. These studies are of particular interest in the field of obstetrics and gynecology, in which uncertainty from epidemiologic or clinical trials exists, or multiple perspectives need to be considered (maternal, neonatal, and societal). As with all research, it is essential that economic evaluations are conducted according to established methodologic standards. Interpretation and application of results should occur with a clear understanding of both the value and the limitations of economic evaluations.Current opinion in obstetrics & gynecology 10/2013; DOI:10.1097/GCO.0000000000000020 · 2.49 Impact Factor
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ABSTRACT: Policy Points: The US publicly supported family planning effort serves millions of women and men each year, and this analysis provides new estimates of its positive impact on a wide range of health outcomes and its net savings to the government. The public investment in family planning programs and providers not only helps women and couples avoid unintended pregnancy and abortion, but also helps many thousands avoid cervical cancer, HIV and other sexually transmitted infections, infertility, and preterm and low birth weight births. This investment resulted in net government savings of $13.6 billion in 2010, or $7.09 for every public dollar spent.Milbank Quarterly 10/2014; DOI:10.1111/1468-0009.12080 · 5.06 Impact Factor
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ABSTRACT: Objectives. We examined the association of adolescent birthrates (ABRs) with access to and receipt of publicly funded family planning services in California counties provided through 2 state programs: Medi-Cal, California's Medicaid program, and the Family Planning, Access, Care, and Treatment (Family PACT) program. Methods. Our key data sources included the California Health Interview Survey and California Women's Health Survey, Medi-Cal and Family PACT claims data, and the Birth Statistical Master File. We constructed a linear regression analysis measuring the relationship of access to and receipt of family planning services with ABRs when controlling for counties' select covariates. Results. The regression analysis indicated that a higher access rate to Family PACT in a county was associated with a lower ABR (B = -0.19; P < .01) when controlling for unemployment rate, percentage of foreign-born adolescents, and percentage of adult low-income births. Conclusions. Efforts to reduce ABRs, specifically in counties that had persistently high rates are critical to achieving a healthy future for the state and the nation. Family PACT played a crucial role in helping adolescents avoid unintended and early childbearing. (Am J Public Health. Published online ahead of print December 19, 2013: e1-e6. doi:10.2105/AJPH.2013.301454).American Journal of Public Health 12/2013; DOI:10.2105/AJPH.2013.301454 · 3.93 Impact Factor