51 DISPARITIES IN ACCESS TO INFERTILITY CARE IN THE UNITED STATES: ANALYSIS OF POPULATION-BASED DATA FROM THE 2002 AND 2006-2008 MALE SAMPLE OF THE NATIONAL SURVEY FOR FAMILY GROWTH

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes1 Apr 201151 DISPARITIES IN ACCESS TO INFERTILITY CARE IN THE UNITED STATES: ANALYSIS OF POPULATION-BASED DATA FROM THE 2002 AND 2006-2008 MALE SAMPLE OF THE NATIONAL SURVEY FOR FAMILY GROWTH James F. Smith, Michael L. Eisenberg, Susan G. Millstein, Marcelle I. Cedars, Ajay Nangia, Judy E. Stern, and Patricia P. Katz James F. SmithJames F. Smith San Francisco, CA More articles by this author , Michael L. EisenbergMichael L. Eisenberg Houston, TX More articles by this author , Susan G. MillsteinSusan G. Millstein San Francisco, CA More articles by this author , Marcelle I. CedarsMarcelle I. Cedars San Francisco, CA More articles by this author , Ajay NangiaAjay Nangia Kansas City, CA More articles by this author , Judy E. SternJudy E. Stern Lebanon, NH More articles by this author , and Patricia P. KatzPatricia P. Katz San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2653AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The high cost of infertility care limits the use of these services. Insurance coverage may allow for better access to these services. We sought to understand the role of insurance coverage in accessing infertility care in a nationally representative sample of men. METHODS We analyzed data from the male samples of the 2002 and 2006–2008 National Survey of Family Growth to examine the relationship between insurance status and utilization of infertility care among men aged 18–45 (n = 8,542). Age, race, education, income, religion, prior paternity, and desire for additional children were analyzed to assess associations with insurance status and infertility treatment utilization. RESULTS Among these men, 6% had ever used infertility services, 0.7% were currently seeking infertility care, 63% had private health insurance, 27% had very limited or no health insurance, 7% had Medicaid or other state-sponsored insurance, and 3% had military or governmental coverage. Relative to men with private insurance, those covered by Medicaid (OR 0.40, p=0.001), miltary insurance or other government insurance (OR 0.45, p=0.01), or no insurance (OR 0.43, p < 0.001) were much less likely to have ever used infertility services. After adjustment for age, demographic, socioeconomic, and reproductive characteristics, these differences persisted, but were no longer statistically significant. For men currently seeking fertility care, relative to men with private insurance, those covered by Medicaid (OR 0.04, p=0.002), military insurance or other government insurance (OR 0.03, p=0.001), or no insurance (OR 0.23, p=0.001) were much less likely to be currently seeking infertility services. These differences persisted among these men after adjustment for age and socioeconomic status. CONCLUSIONS Health insurance coverage is an important marker of access to infertility services. Coverage with private insurance was strongly associated with education, income, race, and age. Even after adjustment for these factors, disparities in insurance coverage were associated with a significant decline in access to reproductive care. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e22 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information James F. Smith San Francisco, CA More articles by this author Michael L. Eisenberg Houston, TX More articles by this author Susan G. Millstein San Francisco, CA More articles by this author Marcelle I. Cedars San Francisco, CA More articles by this author Ajay Nangia Kansas City, CA More articles by this author Judy E. Stern Lebanon, NH More articles by this author Patricia P. Katz San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...