Restricting abortion access will increase the demand for emergency contraception (EC), according to a recent study in JAMA Network Open.
Takeaways
- The study suggests that restricting abortion access is likely to lead to an increased demand for emergency contraception (EC).
- The FDA's approval of over-the-counter (OTC) EC for adults in 2006, extended to minors in 2013, and the Affordable Care Act in 2012, which mandated insurance coverage for EC, contributed to increased accessibility and use.
- Over the period from 2006 to 2020, there was a substantial decrease (96%) in emergency department (ED) encounters related to emergency contraception, indicating a notable shift in trends.
- Certain demographic groups, including Black, Hispanic, younger, low-income, and Medicaid-insured patients, were significantly more represented in EC-related emergency department visits compared to non-EC visits. This suggests potential disparities in access and utilization.
- There was a notable geographic variation in EC-related ED visits, with a higher percentage in northeast hospitals compared to non-EC visits. The results emphasize the importance of considering regional differences in understanding emergency contraception trends.
On August 24, 2006, the FDA approved the use of over-the-counter (OTC) EC in adults, with this approval being extended to minors in 2013. This led to an increase in EC use, along with the Patient Protection and Affordable Care Act in 2012, which mandated insurances cover EC.
While emergency departments (EDs) provide 24-hour access to ECs, there is little data evaluating EC-related ED utilization trends. To identify these trends, investigators conducted a cross-sectional study.
The nationwide Emergency Department Sample, which includes 2,006,582,771 weighted US ED visits from 2006 to 2020, was evaluated for data on EC-related ED use. Participants included female individuals with an ICD-9 or ICD-10 code of EC.
Annual EC-related ED visits and hospital charges were reported as the primary outcomes of the analysis, stratified based on age, hospital geographic region, payment method, and income quartile.To identify disparities in EC ED use, race and ethnicity data was also obtained for patients from 2019 to 2020.Non-EC diagnoses were also evaluated to compare overall vs EC-specific ED use trends.
There were 47,858 EC-related ED encounters from 2006 to 2020 included in the analysis. A decrease in encounters of 96% was observed during this period, with 17,019 reported in 2006 and 659 in 2020.
Total EC-related hospital charges also decreased between 2006 and 2020, from $7.61 million in 2006 to $385,946 in 2020. Primary EC diagnoses had the most significant reduction, which was seen between 2006 and 2007.
Black, Hispanic, younger, low-income, and Medicaid-insured patients were significantly more represented in EC-related visits compared to non-EC ED visits. Of EC-related ED visits, 43.9% to 58.6% were in northeast hospitals. In comparison, these hospitals comprised of only 17.1% to 19.1% of non-EC ED visits.
These results indicated restricting abortion access will increase EC demand. Investigators recommended future policies remove barriers for EC.
Reference
Vogt EL, Chibber S, Jiang C, et al. Trends in encounters for emergency contraception in US emergency departments, 2006-2020. JAMA Netw Open. 2024;7(1):e2353672. doi:10.1001/jamanetworkopen.2023.53672
