Cargando…

Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic

OBJECTIVES: To understand how changes to in-person health care during the COVID pandemic impacted contraceptive use in Oregon’s state-funded network. STUDY DESIGN: A retrospective cohort of 245,600 visits (virtual and in-person) among 70,295 women presenting to publicly funded family planning clinic...

Descripción completa

Detalles Bibliográficos
Autores principales: Rodriguez, Maria I., Skye, Megan, Schrote, Kaitlin, Linz, Rachel, Pedhiwala, Nisreen, Liberty, Abigail, Fuerst, Megan, Edelman, Alison B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122546/
https://www.ncbi.nlm.nih.gov/pubmed/37088123
http://dx.doi.org/10.1016/j.contraception.2023.110054
_version_ 1785029513701228544
author Rodriguez, Maria I.
Skye, Megan
Schrote, Kaitlin
Linz, Rachel
Pedhiwala, Nisreen
Liberty, Abigail
Fuerst, Megan
Edelman, Alison B.
author_facet Rodriguez, Maria I.
Skye, Megan
Schrote, Kaitlin
Linz, Rachel
Pedhiwala, Nisreen
Liberty, Abigail
Fuerst, Megan
Edelman, Alison B.
author_sort Rodriguez, Maria I.
collection PubMed
description OBJECTIVES: To understand how changes to in-person health care during the COVID pandemic impacted contraceptive use in Oregon’s state-funded network. STUDY DESIGN: A retrospective cohort of 245,600 visits (virtual and in-person) among 70,295 women presenting to publicly funded family planning clinics in Oregon between January 2019 and June 2021. Data were abstracted from clinic records and restricted to visits of patients identifying as female, 12–51 years old, not using sterilization as a method. Contraception was grouped by effectiveness Tier (Tier 1: intrauterine device, implants; Tier 2: progestin injectable, pill/patch/ring). Multivariable logistic regression predicted the use of contraception by stage of the COVID pandemic which corresponded to service availability (prepandemic, acute: nonemergency services halted, subacute: restricted services), patient demographics, including insurance type, and clinic and geospatial characteristics. RESULTS: Overall during the acute stage, people with visits were more likely to leave with a method of contraception odds ratios (OR) 1.39 (95% confidence interval [CI] 1.24–1.57); however, it was significantly less likely to be a Tier 1 method (OR 0.82, 95% CI 0.74–0.91) as compared to prepandemic. This finding was particularly marked in rural areas (OR 0.69 [96% CI 0.58–0.83]) and among the publicly insured (OR 0.87 [95% CI 0.80–0.94]). CONCLUSIONS: Demand for contraception increased during the acute phase of the COVID pandemic, and shifts in method mix from Tier 1 to Tier 2 methods occurred. Disparities in contraceptive access persisted for those in rural locations or with public insurance. IMPLICATIONS: Lessons learned from the COVID-19 pandemic are critical to informing our future emergency response. The need for family planning services increased during the public health emergency.
format Online
Article
Text
id pubmed-10122546
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier Inc.
record_format MEDLINE/PubMed
spelling pubmed-101225462023-04-24 Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic Rodriguez, Maria I. Skye, Megan Schrote, Kaitlin Linz, Rachel Pedhiwala, Nisreen Liberty, Abigail Fuerst, Megan Edelman, Alison B. Contraception Original Research Article OBJECTIVES: To understand how changes to in-person health care during the COVID pandemic impacted contraceptive use in Oregon’s state-funded network. STUDY DESIGN: A retrospective cohort of 245,600 visits (virtual and in-person) among 70,295 women presenting to publicly funded family planning clinics in Oregon between January 2019 and June 2021. Data were abstracted from clinic records and restricted to visits of patients identifying as female, 12–51 years old, not using sterilization as a method. Contraception was grouped by effectiveness Tier (Tier 1: intrauterine device, implants; Tier 2: progestin injectable, pill/patch/ring). Multivariable logistic regression predicted the use of contraception by stage of the COVID pandemic which corresponded to service availability (prepandemic, acute: nonemergency services halted, subacute: restricted services), patient demographics, including insurance type, and clinic and geospatial characteristics. RESULTS: Overall during the acute stage, people with visits were more likely to leave with a method of contraception odds ratios (OR) 1.39 (95% confidence interval [CI] 1.24–1.57); however, it was significantly less likely to be a Tier 1 method (OR 0.82, 95% CI 0.74–0.91) as compared to prepandemic. This finding was particularly marked in rural areas (OR 0.69 [96% CI 0.58–0.83]) and among the publicly insured (OR 0.87 [95% CI 0.80–0.94]). CONCLUSIONS: Demand for contraception increased during the acute phase of the COVID pandemic, and shifts in method mix from Tier 1 to Tier 2 methods occurred. Disparities in contraceptive access persisted for those in rural locations or with public insurance. IMPLICATIONS: Lessons learned from the COVID-19 pandemic are critical to informing our future emergency response. The need for family planning services increased during the public health emergency. Elsevier Inc. 2023-07 2023-04-22 /pmc/articles/PMC10122546/ /pubmed/37088123 http://dx.doi.org/10.1016/j.contraception.2023.110054 Text en © 2023 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research Article
Rodriguez, Maria I.
Skye, Megan
Schrote, Kaitlin
Linz, Rachel
Pedhiwala, Nisreen
Liberty, Abigail
Fuerst, Megan
Edelman, Alison B.
Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title_full Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title_fullStr Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title_full_unstemmed Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title_short Contraceptive services in Oregon’s state-funded network during the COVID-19 pandemic
title_sort contraceptive services in oregon’s state-funded network during the covid-19 pandemic
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122546/
https://www.ncbi.nlm.nih.gov/pubmed/37088123
http://dx.doi.org/10.1016/j.contraception.2023.110054
work_keys_str_mv AT rodriguezmariai contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT skyemegan contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT schrotekaitlin contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT linzrachel contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT pedhiwalanisreen contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT libertyabigail contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT fuerstmegan contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic
AT edelmanalisonb contraceptiveservicesinoregonsstatefundednetworkduringthecovid19pandemic