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Distance traveled for Medicaid-covered abortion care in California.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Abortion

Access

Medicaid

Rural

Travel distance

Journal Title bmc health services research
Publication Year Start




PMID- 28420438
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170421
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 19
TI  - Distance traveled for Medicaid-covered abortion care in California.
PG  - 287
LID - 10.1186/s12913-017-2241-0 [doi]
AB  - 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.
FAU - Johns, Nicole E
AU  - Johns NE
AD  - Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global 
      Reproductive Health, Department of Obstetrics, Gynecology and Reproductive
      Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100,
      Oakland, CA, 94612, USA. [email protected]
FAU - Foster, Diana Greene
AU  - Foster DG
AD  - Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global 
      Reproductive Health, Department of Obstetrics, Gynecology and Reproductive
      Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100,
      Oakland, CA, 94612, USA.
FAU - Upadhyay, Ushma D
AU  - Upadhyay UD
AD  - Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global 
      Reproductive Health, Department of Obstetrics, Gynecology and Reproductive
      Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100,
      Oakland, CA, 94612, USA.
LA  - eng
PT  - Journal Article
DEP - 20170419
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
PMC - PMC5395766
OTO - NOTNLM
OT  - Abortion
OT  - Access
OT  - Medicaid
OT  - Rural
OT  - Travel distance
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
PHST- 2016/08/19 [received]
PHST- 2017/04/10 [accepted]
AID - 10.1186/s12913-017-2241-0 [doi]
AID - 10.1186/s12913-017-2241-0 [pii]
PST - epublish
SO  - BMC Health Serv Res. 2017 Apr 19;17(1):287. doi: 10.1186/s12913-017-2241-0.

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