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GP Cash Incentives Associated with Falling UK Abortion Rates, Study Results | Contraception and family planning



The scheme that provided cash incentives for GP surgery to inform women about long-lasting reversible contraception methods was associated with a sharp drop in abortion rates.

Long-lasting reversible contraceptives known as Larcs include implants, intrauterine devices, and contraceptive injections and are very effective.

Researchers found that in 2009 when GPs in the UK received financial incentives to inform women about such methods of contraception, intake increased and abortion rates fell markedly, especially among younger women and those with more vulnerable backgrounds.

The study sparked a call to restore the incentive system that was scrapped this year.

Financial incentives are usually used in the healthcare setting to encourage certain interventions, including flu vaccination.

In 2009/10, the UK government introduced a system to pay for GP surgery reaching its goal of providing information about Larcs to female patients aged 13 to 54 who had previously used prescription contraceptives, including morning-to-post contraceptives. I did. Incentives are not related to the actual use of the method.

Overall, the team says that if they care about 6,000 patients, more than 90% of eligible women, with Larc’s advice, equate to financial support for about 700 cares per year.

The incentive scheme was partially abolished on 2014/15 and completely abolished by 2019/20.

The researchers reported in the journal PLOS Medicine how they analyzed the health records of more than 3 million women in the UK, Wales and Scotland over the period 2004/05 to 2013/14.

The research team looked at trends in prescriptions and abortions for a variety of contraceptives before the introduction of the incentive scheme, and used them to predict the expected number of prescriptions and abortions for other contraceptives in 2013/14. .

Looking at our own figures for 2013/14, we found that the number of Larc prescriptions was 13% higher than expected in the trend before the incentive scheme was introduced. In contrast, the total prescription of other hormonal contraceptives was 17% lower than expected.

The study’s co-author, Dr. Richard Ma of Imperial College London, said the findings are unlikely that an increase in Larc use will have a significant impact on an increase in general awareness of contraception, but it is potentially a result of women’s transition to better ways. Said. Way for them.

Although abortion rates were already falling before the system was introduced, the number of abortions in 2013/14 was 38% lower than expected.

The trend of abortion is going down fairly slowly, but it has come down a lot more since incentives were introduced, Ma said.

Ma said it is not known whether the GP will continue to provide information about Larcs to women, and whether the abolition of the incentive system has affected measures such as abortion rates.

Giving women more options for contraception with or without incentives is definitely a good habit, he said.

Dr. Asha Kasliwal from the Faculty of Sexual and Reproductive Medicine said financial incentives should be restored. They pointed out that fewer and fewer women have access to contraception in primary care due to factors including budget cuts.

[The study shows] Patients are more likely to try these methods if GPs have more time and are duly supported to provide information about intrauterine contraception, contraceptive implants and injections, she said. It is a win-win situation for both doctors and patients.

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