201423 Increasing access to long-acting, reversible contraception: An innovative initiative

Wednesday, November 11, 2009: 8:50 AM

Kristin Simonson, MA , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Mitchel Hawkins , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Marissa Gonzalez , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Maura Fulton , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Jody Steinauer, MD, MAS , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Uta Landy, PhD , Ryan Residency Training Program, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
  
Objectives: The goal of this initiative is to increase access to long-acting, reversible contraceptive devices by eliminating cost barriers for post-partum or post-abortion patients at ob-gyn departments that have participated in the Kenneth J. Ryan Residency Training Program, a national program providing financial and technical assistance to ob-gyn departments to improve training in family planning and abortion.

Methods: LARC devices (IUDs and Implanon) are provided to participating ob-gyn departments for post-abortion or post-partum patients who: are below 300% of the federal poverty level; lack insurance coverage for LARC; are not able to afford out of pocket insurance cost for LARC; have a medically indicated need for LARC but no resources or insurance coverage; the LARC device is not covered by Medicaid. Non-identifying information about patients receiving LARC devices is collected by participating programs.

Results: 2,523 women have received LARC devices since program initiation in May 2008; by the end of 2009 we expect to provide 8,000 total devices.

Device Placed

Implanon 447 (18%)

Mirena 1,580 (63%)

Paragard 496 (20%)

Ethnicity

Hispanic 1,110 (44%)

Non-Hispanic 1,288 (51%)

Not available 92 (4%)

Race

African American 1,001 (40%)

Caucasian 577 (23%)

Other 803 (32%)

Federal Poverty Level

<200% 1,171 (46%)

<300% 772 (31%)

Eligibility

No insurance 1,322 (52%)

Excessive copay 72 (3%)

Medically indicated 53 (2%)

Other 26 (1%)

Conclusions: The Ryan LARC Initiative has successfully increased access to LARC for women who experience financial barriers in obtaining a method of contraception meeting their family planning needs.

Learning Objectives:
Evaluate the impact of an initiative to increase access to long-acting, reversible contraception. Describe characteristics of women who choose long-acting, reversible contraceptive methods.

Keywords: Contraception, Underserved

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I manage all aspects of the Ryan LARC Program in my position as Outreach Manager at the National Office of the Kenneth J. Ryan Residency Program. I have managed and evaluated various projects concerning reproductive health and professional training for 3 years. I am a participating author on a poster accepted for the 2009 CREOG/APGO Annual Meeting, Implementing Resident Training in Induced Abortion: Summary of Ryan Programs in Ob-Gyn Residency Programs in the US and Canada. I hold a Master of Arts in Political Science.
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.

See more of: Long-Acting Reversible Contraceptives (LARC)
See more of: Population, Reproductive and Sexual Health