Normal view MARC view ISBD view

Continuation of long-acting reversible contraceptives among Medicaid patients.

MedStar author(s):

Citation: Contraception. 2018 Apr 24PMID: 29702080Institution: MedStar Franklin Square Medical Center | MedStar Washington Hospital CenterDepartment: MedStar Family Choice | NursingForm of publication: Journal ArticleMedline article type(s): Journal ArticleYear: 2018 Local holdings: Available online from MWHC library: 1995 - presentISSN:

0010-7824

Name of journal: ContraceptionAbstract: CONCLUSION: Among a sample of 15-44-year-old Medicaid recipients, both implants and IUDs had high continuation rates and low complication rates; however, implants were slightly more likely than IUDs to remain in use one year after insertion.Copyright (c) 2018. Published by Elsevier Inc.IMPLICATIONS: Among 15-44-year-old Medicaid recipients, both etonogestrel implants and intrauterine devices have high continuation rates and low complication rates at 1-year post-insertion; however, implants are slightly more likely than IUDs to remain in use at one year.OBJECTIVE: Our objective was to compare continuation and complication rates of subdermal etonogestrel implants and intrauterine devices (IUDs) using Medicaid insurance claims.RESULTS: 3,103 subjects received 1,335 implants and 1,970 IUDs, with implants more common than IUDs among subjects 15-19 years old (rate ratio 2.42), and implants less common than IUDs for subjects 20-44 years old (rate ratio 0.54). Implants had higher continuation rates at one year than IUDs (81.0% vs. 76.7%, p=0.01). The difference was larger among subjects 25 to 44 years old (84.1% vs. 79.3%, p=0.03) compared with subjects 15 to 19 years old (89.5% vs. 86.8%, p=0.09) and subjects 20 to 24 years old (75.7% vs. 73.2%, p=0.44). Claims for potential complications were similarly uncommon for both implants and IUDs (8.09% vs. 6.95%, p=0.65), as were claims for pregnancies prior to LARC removal (0.82% vs. 0.86%, p=0.86).STUDY DESIGN: We performed a retrospective cohort study using insurance claims data for 15- to 44-year-old subjects receiving implants or IUDs from 2012 to 2015 in a Medicaid managed care organization in Washington, DC, and Maryland. We performed a planned Kaplan-Meier survival analysis for long-acting reversible contraceptive (LARC) continuation, defined as the absence of a claim for LARC removal, during periods of continuous insurance plan enrollment.All authors: Patchen L, Romano MJ, Toye PFiscal year: FY2018Digital Object Identifier:

https://dx.doi.org/10.1016/j.contraception.2018.04.012

Date added to catalog: 2018-05-08

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	29702080	Available		29702080

Available online from MWHC library: 1995 - present

CONCLUSION: Among a sample of 15-44-year-old Medicaid recipients, both implants and IUDs had high continuation rates and low complication rates; however, implants were slightly more likely than IUDs to remain in use one year after insertion.

IMPLICATIONS: Among 15-44-year-old Medicaid recipients, both etonogestrel implants and intrauterine devices have high continuation rates and low complication rates at 1-year post-insertion; however, implants are slightly more likely than IUDs to remain in use at one year.

OBJECTIVE: Our objective was to compare continuation and complication rates of subdermal etonogestrel implants and intrauterine devices (IUDs) using Medicaid insurance claims.

RESULTS: 3,103 subjects received 1,335 implants and 1,970 IUDs, with implants more common than IUDs among subjects 15-19 years old (rate ratio 2.42), and implants less common than IUDs for subjects 20-44 years old (rate ratio 0.54). Implants had higher continuation rates at one year than IUDs (81.0% vs. 76.7%, p=0.01). The difference was larger among subjects 25 to 44 years old (84.1% vs. 79.3%, p=0.03) compared with subjects 15 to 19 years old (89.5% vs. 86.8%, p=0.09) and subjects 20 to 24 years old (75.7% vs. 73.2%, p=0.44). Claims for potential complications were similarly uncommon for both implants and IUDs (8.09% vs. 6.95%, p=0.65), as were claims for pregnancies prior to LARC removal (0.82% vs. 0.86%, p=0.86).

STUDY DESIGN: We performed a retrospective cohort study using insurance claims data for 15- to 44-year-old subjects receiving implants or IUDs from 2012 to 2015 in a Medicaid managed care organization in Washington, DC, and Maryland. We performed a planned Kaplan-Meier survival analysis for long-acting reversible contraceptive (LARC) continuation, defined as the absence of a claim for LARC removal, during periods of continuous insurance plan enrollment.

English