268659 Onsite provision of long-acting contraception: A comparison of Title X and non-Title X providers in California

Monday, October 29, 2012 : 8:30 AM - 8:50 AM

Heike Thiel de Bocanegra, PhD, MPH , Assistant Professor and Director, UCSF Family PACT Evaluation, University of California, San Francisco, Sacramento, CA
Julie Cross Riedel, PhD MPH , Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Sacramento, CA
Fran Maguire , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Philip Darney, MD, MSc , Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Use of long-acting contraception (LAC) is recommended to reduce unintended pregnancy. Provision of LAC methods requires extra skill and training and clients are often referred elsewhere to obtain these services, presenting a barrier to accessing services. Family PACT, California's Medicaid family planning expansion, has a diverse provider network comprised of public sector providers receiving Title X funding, non-Title X funded public sector providers and private providers. This analysis explores the extent to which these three provider groups differ in their onsite provision of LAC, by using Family PACT claims data matched to results from a provider survey. A significantly greater proportion of providers from Title X-funded clinics provided onsite services for reversible methods and vasectomies: implants (58% Title X, 19% non-Title X, 7% private providers); intrauterine contraceptives (90% Title X, 51% non-Title X, 38% private); and vasectomies (8% Title X, 4% non-Title X, 1% private). The higher proportions among Title X providers were found regardless of clinic size, specialty or rural/urban location. A higher proportion of private providers (24%) had claims for tubal ligations which need to be provided at surgi-centers (4% Title X, 6% non-Title X); whereas there was no difference among the provider groups in offering tubal occlusions. Title X funding appears to play an important role in increasing access to LAC and enabling access to a wider range of contraceptive services. This data will be used to estimate averted births and saved costs that result from the increased likelihood of LAC use at Title X clinics.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related nursing

Learning Objectives:
1. List three long-acting contraceptive methods 2. Describe the importance of providing contraceptive services onsite 3. List three provider characteristics that influence onsite provision of long-acting contraception

Keywords: Contraceptives, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the director of the UCSF Family PACT evaluation and co-investigator on the OPA funded study that will 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.