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Distance traveled for Medicaid-covered abortion care in California
BACKGROUND: Access to abortion care in the United States is limited by the availability of abortion providers and their geographic distribution. We aimed to assess how far women travel for Medicaid-funded abortion in California and identify disparities in access to abortion care. METHODS: We obtaine...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395766/ https://www.ncbi.nlm.nih.gov/pubmed/28420438 http://dx.doi.org/10.1186/s12913-017-2241-0 |
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author | Johns, Nicole E. Foster, Diana Greene Upadhyay, Ushma D. |
author_facet | Johns, Nicole E. Foster, Diana Greene Upadhyay, Ushma D. |
author_sort | Johns, Nicole E. |
collection | PubMed |
description | BACKGROUND: Access to abortion care in the United States is limited by the availability of abortion providers and their geographic distribution. We aimed to assess how far women travel for Medicaid-funded abortion in California and identify disparities in access to abortion care. METHODS: We obtained data on all abortions reimbursed by the fee-for-service California state Medicaid program (Medi-Cal) in 2011 and 2012 and examined distance traveled to obtain abortion care by several demographic and abortion-related factors. Mixed-effects multivariable logistic regression models were constructed to examine factors associated with traveling 50 miles or more. County-level t-tests and linear regressions were conducted to examine the effects of a Medi-Cal abortion provider in a county on overall and urban/rural differences in utilization. RESULTS: 11.9% (95% CI: 11.5–12.2%) of women traveled 50 miles or more. Women obtaining second trimester or later abortions (21.7%), women obtaining abortions at hospitals (19.9%), and rural women (51.0%) were most likely to travel 50 miles or more. Across the state, 28 counties, home to 10% of eligible women, did not have a facility routinely providing Medi-Cal-covered abortions. CONCLUSIONS: Efforts are needed to expand the number of abortion providers that accept Medi-Cal. This could be accomplished by increasing Medi-Cal reimbursement rates, increasing the types of providers who can provide abortions, and expanding the use of telemedicine. If national trends in declining unintended pregnancy and abortion rates continue, careful attention should be paid to ensure that reduced demand does not lead to greater disparities in geographic and financial access to abortion care by ensuring that providers accepting Medicaid payment are available and widely distributed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2241-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5395766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53957662017-04-20 Distance traveled for Medicaid-covered abortion care in California Johns, Nicole E. Foster, Diana Greene Upadhyay, Ushma D. BMC Health Serv Res Research Article BACKGROUND: Access to abortion care in the United States is limited by the availability of abortion providers and their geographic distribution. We aimed to assess how far women travel for Medicaid-funded abortion in California and identify disparities in access to abortion care. METHODS: We obtained data on all abortions reimbursed by the fee-for-service California state Medicaid program (Medi-Cal) in 2011 and 2012 and examined distance traveled to obtain abortion care by several demographic and abortion-related factors. Mixed-effects multivariable logistic regression models were constructed to examine factors associated with traveling 50 miles or more. County-level t-tests and linear regressions were conducted to examine the effects of a Medi-Cal abortion provider in a county on overall and urban/rural differences in utilization. RESULTS: 11.9% (95% CI: 11.5–12.2%) of women traveled 50 miles or more. Women obtaining second trimester or later abortions (21.7%), women obtaining abortions at hospitals (19.9%), and rural women (51.0%) were most likely to travel 50 miles or more. Across the state, 28 counties, home to 10% of eligible women, did not have a facility routinely providing Medi-Cal-covered abortions. CONCLUSIONS: Efforts are needed to expand the number of abortion providers that accept Medi-Cal. This could be accomplished by increasing Medi-Cal reimbursement rates, increasing the types of providers who can provide abortions, and expanding the use of telemedicine. If national trends in declining unintended pregnancy and abortion rates continue, careful attention should be paid to ensure that reduced demand does not lead to greater disparities in geographic and financial access to abortion care by ensuring that providers accepting Medicaid payment are available and widely distributed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2241-0) contains supplementary material, which is available to authorized users. BioMed Central 2017-04-19 /pmc/articles/PMC5395766/ /pubmed/28420438 http://dx.doi.org/10.1186/s12913-017-2241-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Johns, Nicole E. Foster, Diana Greene Upadhyay, Ushma D. Distance traveled for Medicaid-covered abortion care in California |
title | Distance traveled for Medicaid-covered abortion care in California |
title_full | Distance traveled for Medicaid-covered abortion care in California |
title_fullStr | Distance traveled for Medicaid-covered abortion care in California |
title_full_unstemmed | Distance traveled for Medicaid-covered abortion care in California |
title_short | Distance traveled for Medicaid-covered abortion care in California |
title_sort | distance traveled for medicaid-covered abortion care in california |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395766/ https://www.ncbi.nlm.nih.gov/pubmed/28420438 http://dx.doi.org/10.1186/s12913-017-2241-0 |
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