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Increasing the accessibility of long-acting reversible contraceptives through nurse-led insertions: A cost-benefit analysis

journal contribution
posted on 09.12.2020, 05:41 by JR Botfield, S Lacey, K Fleming, K McGeechan, Deborah Bateson
© 2019 Australian College of Nursing Ltd

Background: Long-acting reversible contraceptives (LARCs) are highly effective in preventing pregnancy; however, uptake remains relatively low in Australia. Extending provision by registered nurses (RNs) with the required knowledge and skills may increase accessibility of these contraceptive methods. Methods: A cost-benefit analysis was undertaken to assess the impact of Australian women switching from an oral contraceptive pill (OCP) to a LARC, or initiating the use of a LARC for women not currently using any form of contraception, over five years. The additional impact of 20% of the increase in LARC insertions being carried out by RNs was also modelled. Findings: If women using the OCP switched to LARC, in-line with LARC uptake in comparable countries, net savings are estimated at $68 million over five years, given the significant out-of-pocket expenses associated with the OCP. For women using no contraception who adopt a LARC, in-line with uptake in comparable countries, the value of avoided abortions and miscarriages is $20 million over five years. If 20% of women who switch to a LARC are provided with services by a RN (compared to a GP), there would be an additional cost saving to government of $2.7 million. Further savings for women due to lower out-of-pocket costs for insertion are valued at $500,000 over five years. Conclusion: Enabling RN-led LARC insertion is a cost-effective way of increasing accessibility to these contraceptive methods. The creation of Medicare Benefits Schedule item numbers for RNs appropriately trained in LARC insertion and removal would have benefits for both women and the Australian government.

History

Publication Date

01/02/2020

Journal

Collegian

Volume

27

Issue

1

Pagination

6p. (p. 109-114)

Publisher

Elsevier

ISSN

1322-7696

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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