Research paper over austin county texas
The authors designed the study, and the funder had no role in the analysis or interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication. We estimated the discontinuity in the differences at the point of the exclusion with the indicator for post-exclusion. 2% from baseline (−22. 001). 5 This sharp curtailment of the family-planning safety net in Texas occurred before the 2013 exclusion of Planned Parenthood affiliates from the fee-for-service family-planning program. We then separated each set of claims into those that were filed in counties that had a Planned Parenthood affiliate in 2011 and those that were filed in counties without such an affiliate at that time. These features of the method allowed us to observe changes in the rate of childbirth within 18 months after the claim, which would not be possible with LARC methods (which last longer) or oral contraceptive pills (which may be dispensed for a single month or up to 12 months per claim). The 23 counties with Planned Parenthood affiliates were home to 60% of female Texas residents between the ages of 18 and 44 years who were living at or below 185% of the federal poverty level ( Table 1 Table 1 Characteristics of Counties, According to the Presence or Absence of Planned Parenthood Affiliates before Exclusion. All the authors vouch for the integrity and completeness of the data and analyses. 9 percentage points divided by 56. We used all program claims from 2011 through 2014 to examine changes in the number of claims for contraceptives according to method for 2 years before and 2 years after the exclusion. Obstet Gynecol 2009;114:1434-1438 In order to assess changes in the rates of contraceptive continuation and subsequent childbirth covered by Medicaid associated with the exclusion of Planned Parenthood affiliates, we focused on women who were using an injectable contraceptive. In the period before the exclusion, there were 82 closures of family-planning clinics in Texas, 5 and the decrease in the number of family-planning clinics was greater in research paper over austin county texas counties without Planned Parenthood affiliates than in those with such affiliates. 9% to 37. In contrast, the provision of short-acting hormonal methods changed little in the two groups of counties in the quarter after the exclusion and declined steadily thereafter. In the quarter after the exclusion, there was a sharp decrease in the number of claims for LARC methods in counties with Planned Parenthood affiliates but not in those without such affiliates. 9 percentage points; P<0. Using billing records, we identified the women on the basis of the presence of a medical claim that included one or more of the Current Procedural Terminology codes for a valid family-planning service or a pharmacy claim that included an appropriate national pharmacy code for a contraceptive method. Specifically, the how to write a preface for a dissertation percentage of women decreased from 56. We also assessed the quarterly volume of program claims for contraceptives, according to method, for counties with Planned Parenthood affiliates and those without such affiliates during the 16 observed quarters (8 before and 8 after the exclusion). In keeping with the eligibility criteria of the programs, all women who were receiving services were fertile, legal Texas residents between the ages of 18 and 44 years with incomes at or below 185% of the federal poverty level. 450: increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. After the exclusion, the provision of injectable contraceptives fell sharply in counties with Planned Parenthood affiliates but not in counties without such affiliates; subsequently, the numbers of claims in both groups of counties remained relatively stable during the next 2 years. Unlike other forms of contraception, this method requires regular provider visits and has a relatively short span of contraceptive effectiveness (3 months). The institutional review board at the University of Texas at Austin determined that the study was exempt from human-subjects review; therefore, no informed consent was required. This change represents a relative decrease of 40. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. We calculated the buy a college paper online difference in differences between the two cohorts and groups of counties. The Texas legislature did this by removing Title V and Title XX family-planning funding and requiring the initiation of a new, tiered grant-award process favoring county health departments, community health centers, and other comprehensive care providers. 8 In these models, we allowed the slopes and intercepts to vary before and after the exclusion by using an indicator that was equal to 1 after the exclusion and 0 before the exclusion and an interaction between this indicator and time. The exclusion of Planned Parenthood affiliates from a state-funded replacement for a Medicaid fee-for-service program in Texas was associated with adverse changes in the provision of contraception. Table 2 Table 2 Rates of Continuation of Contraceptive Provision and of Childbirth Covered by Medicaid among Women Using Injectable Contraceptives. We fitted local do research papers need a conclusion paragraph linear regression models to summarize the differences in volumes for each method. 6 We included two cohorts in our comparison. The proportions of women who had no health insurance were similar in counties with research paper over austin county texas Planned Parenthood affiliates and in those without such affiliates. We research paper over austin county texas first compared the group of counties that had a Planned Parenthood–affiliated clinic with those that did not with respect to the number of women between the ages of 18 and 44 years who had household incomes that would qualify them for the program (≤185% of the federal poverty level), the number of childbirths to legal residents covered by Medicaid, and the proportion of women between the ages of 18 and 44 years who did not have health insurance. (Funded by the Susan T. 7% in counties with Planned Parenthood affiliates but increased from 54. The first cohort received an injection in the fourth quarter of 2011 and thus had a year to continue receiving services before the exclusion of Planned Parenthood affiliates took effect. We also used administrative records from the Texas Department of State Health Services and from Planned Parenthood to categorize counties as either having or not having providers affiliated with Planned Parenthood at the beginning of the study. We also accessed all claims for childbirth covered by Medicaid using unique identifications for two cohorts of women who use injectable contraceptives. On the basis of the quarterly number of claims for each contraceptive method, we calculated the difference in provision between counties with Planned Parenthood affiliates and those without such affiliates for each quarter and each method. The proportion of women returning for a subsequent research paper over austin county texas on-time contraceptive injection in counties with Planned Parenthood affiliates was lower after the exclusion. Among women using injectable contraceptives at baseline, we observed rates of contraceptive continuation through the program and of childbirth covered by Medicaid. , Long-Acting Reversible Contraception Working Group. 9%). ACOG Committee Opinion no. Among women using an injectable contraceptive in counties with Planned Parenthood affiliates and those without such affiliates in the fourth quarters of 2011 and 2012, we also measured the proportion of women who returned to the program for any service, who returned for an on-time subsequent injection, and who underwent childbirth covered by Medicaid during the following 18 months. In subsequent quarters, the number of claims for LARC methods increased in both groups of counties. For women using injectable contraceptives, there was a reduction in the rate of contraceptive continuation and an increase in the rate of childbirth covered by Medicaid. Our data included all pharmacy and medical claims from January 1, 2011, to December 31, 2014, under public fee-for-service family-planning insurance programs in Texas. 5% in counties without such affiliates (estimated difference in differences for counties with affiliates as compared with those without affiliates, −22. Of the 254 counties in Texas, only 23 had clinics affiliated with Planned Parenthood. how to write a fictional narrative essay ) Effective 15 months research paper over austin county texas earlier (on September 1, 2011), Texas had cut family-planning grants (a separate funding stream) by 66% and redistributed the remaining grant funding away from dedicated family-planning providers, such as, but not limited to, Planned Parenthood affiliates. We used the difference-in-differences method to compare outcomes in counties with Planned Parenthood affiliates with outcomes in those without such please help me do my homework affiliates. We obtained these indicators from the American Community Survey, using 5-year averages centered on 2012, and from Texas Medicaid billing records. Finally, we computed the relative change in provision by dividing this discontinuity by the estimated provision in counties with Planned Parenthood affiliates at the point of exclusion (as estimated by means of linear regression). Buffett Foundation. 9% to 58. We retrieved data regarding women’s counties of residence from the eligibility and billing system. Provides a comparison of the rates of continuation of contraception and of childbirth covered by Medicaid between women who received a contraceptive injection in the fourth quarter of 2011 and those who received such an injection in the fourth quarter of 2012. 4 The 2011 reductions in college admissions essay prompts 2010 grants and redistribution of funds were followed by the closure of 82 family-planning clinics, about a third of which were affiliated with Planned Parenthood. Of all the childbirths that legal residents underwent and that were covered by Medicaid in 2012, a total of 63% occurred in counties with Planned Parenthood affiliates. The second cohort received an injection in the fourth quarter of 2012 and thus was subject to the influence of the exclusion before the due date for the next injection. For each quarter, we categorized contraceptive methods into three groups: long-acting reversible contraceptives (LARC; contraceptive implants and help with writing a psychology paper intrauterine devices), an injectable contraceptive (depot medroxyprogesterone acetate), and short-acting hormonal methods (oral contraceptive pills, transdermal contraceptive patches, research paper over austin county texas and contraceptive rings). ). For each college application report writing nursing cohort and county group, we computed the proportions of women who received a service covered by the program in the following quarter, who received an injection in that quarter, and who underwent childbirth covered by Medicaid in the following 18 months.