178537 Role of publicly funded clinics in providing contraceptive and preventive gynecological care to uninsured women

Monday, October 27, 2008: 1:10 PM

Christina I. Fowler, PhD, MPH , Division for Health Services and Social Policy Research, RTI International, Research Triangle Park, NC
Janet B. Mitchell, PhD , Division for Health Services and Social Policy Research, RTI International, Waltham, MA
Jiantong Wang, MS , Statistics & Epidemiology, RTI International, Atlanta, GA
In 2004, 17.4 million women at risk of unintended pregnancy were in need of publicly funded services because of age or income. Women needing publicly funded services are at increased risk for poor reproductive outcomes, including contraceptive failure and unintended pregnancy. Forty percent of women needing publicly funded care are served by the 7,700 publicly funded clinics that comprise the nation's family planning “safety net.” Publicly funded clinics are under great financial strain due to inadequate funding, increased costs of delivering care, and growing demand among newly uninsured and low income populations.

We pooled data from the 1995 and 2002 NSFG surveys to examine trends in the relationship between insurance coverage and use of publicly funded clinics for women at risk of unintended pregnancy, who received any contraceptive (n=4,608) or gynecological service (n=6,318) in the 12 months before the surveys. We estimated logistic regression models and tested differences in the probability of clinic use between years by insurance status. We found that between 1995 and 2002 the probability of using a publicly funded clinic for any contraceptive or preventive gynecological service increased significantly for uninsured and Medicaid-insured women, with the largest percentage increases among uninsured women.

Efforts to reduce unintended pregnancy and poor reproductive health outcomes must account for the role of publicly funded clinics in meeting the reproductive health needs of uninsured women, and examine whether funding (federal and state) to support safety net providers is sufficient to meet this demand.

Learning Objectives:
1. List changes over time in the relationship between health insurance coverage,source of family planning and related preventive health care. Describe the reasons for the observed trends and discuss Discuss the implications for publicly funded family planning clinics.

Keywords: Access and Services, Safety Net Providers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the project, and I have led conceptualization and analysis of the research to be presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.