Contraception
Volume 81, Issue 4, 2010, Pages 304-308

Cost-benefit analysis of state- and hospital-funded postpartum intrauterine contraception at a university hospital for recent immigrants to the United States (Article)

Rodriguez M.I.* , Caughey A.B. , Edelman A. , Darney P.D. , Foster D.G.
  • a Center for Clinical and Policy Perinatal Research, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94110, United States
  • b Center for Clinical and Policy Perinatal Research, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94110, United States
  • c Department of Obstetrics AND Gynecology, Oregon Health and Science University, Portland, OR 97239, United States
  • d Center for Clinical and Policy Perinatal Research, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94110, United States, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA 94110, United States
  • e Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA 94110, United States

Abstract

Objective: To examine the hospital and state costs of offering the option of a postpartum intrauterine device (IUD) to an underinsured population of recent immigrants to the United States with Emergency Medicaid (EM) insurance coverage only. Study Design: This study is a retrospective cohort study comparing the costs of offering a reversible long-acting method of contraception (IUD) postpartum to women with EM and the current policy of covering the obstetrical delivery only. A cost-benefit analysis from the perspective of both the hospital and the state was conducted. A database of EM obstetrical patients from 2002 to 2006 was created from hospital billing records to calculate mean pregnancy costs and revenue, as well as the probability of repeat pregnancy and pregnancy outcome. Probability of IUD uptake and continuation was obtained from hospital records and the literature. Results: A postpartum IUD program is not cost beneficial from the hospital's perspective, losing 70 cents per dollar spent on the program. However, the state government would save $2.94 for every dollar spent on a state-financed IUD program. Conclusion: Considering only the direct costs associated with a repeat pregnancy, a program offering the option of postpartum IUD placement to underinsured women would significantly reduce state expenditures on subsequent pregnancies. © 2010 Elsevier Inc. All rights reserved.

Author Keywords

Cost-benefit analysis Postpartum intrauterine contraception Emergency Medicaid immigrants

Index Keywords

immigrant Cost benefit analysis cost health care policy university hospital health insurance human Cohort Studies probability funding United States Health Care Costs Humans Hospitals, University Emigrants and Immigrants female medical record Contraception pregnancy Article delivery Retrospective Studies pregnancy outcome human experiment government normal human postnatal care hospital hospital billing Intrauterine Devices repeat procedure Delivery, Obstetric Pregnancy, Unplanned intrauterine contraceptive device cost-benefit analysis puerperium
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77949299115&doi=10.1016%2fj.contraception.2009.11.002&partnerID=40&md5=37bd6c1961bba1b82717c11f69eed244
DOI: 10.1016/j.contraception.2009.11.002
ISSN: 00107824
Cited by: 25
Original Language: English