The following is a summary of “Same-day long-acting reversible contraceptive utilization after a statewide contraceptive access initiative,” published in the APRIL 2023 issue of Obstetrics and Gynecology by McColl, et al.
The Delaware Contraceptive Access Now initiative aimed to improve access to the same-day placement of long-acting reversible contraceptives (LARCs) to reduce barriers and unintended pregnancies. Despite the known safety and efficacy of same-day placement, access to these services still needs to be improved. For a study, researchers sought to assess the impact of the Delaware Contraceptive Access Now initiative on the receipt of same-day LARCs, specifically evaluating the effects on individuals enrolled in Medicaid in Delaware and Maryland.
To evaluate the initiative, Medicaid claims, and encounter data were utilized to identify instances of same-day and multi-visit LARC placements among individuals aged 15-44 years who were enrolled in Medicaid and covered under the full benefits or family planning aid category. A difference-in-differences design was employed, comparing changes in the outcome before and after the initiative’s implementation. The analysis included placements at participating agencies in Delaware (n=6676), as well as two comparison groups: placements at non-participating Delaware agencies (n=688) and placements in Maryland (n=35,847).
Implementing the Delaware Contraceptive Access Now initiative was associated with a significant increase in the receipt of same-day LARCs. When compared to the non-participating Delaware comparison group, there was a 13.3 percentage point increase (95% CI, 1.9%-24.7%). Using the Maryland comparison group, the increase was 21.1 percentage points (95% CI, 13.7%-28.6%).
Additionally, a pooled comparison group yielded a 21.0 percentage point increase (95% CI, 14.1%-27.9%). The effects were more pronounced for implants compared to intrauterine devices.
The study’s findings indicated that the Delaware Contraceptive Access Now initiative successfully increased the number of individuals receiving same-day LARCs through a single-visit encounter. The results suggested that a comprehensive approach involving provider and staff training and investments in device stocking can effectively enhance same-day access to LARCs.