Abstract：
BACKGROUND: Financial costs remain one of the greatest barriers to abortion, leading to delays in care and preventing some from getting a desired abortion. Medication abortion is available through in-person facilities and telehealth services. However, whether telehealth offers a more affordable option has not been well-documented.
METHODS: We used Advancing New Standards in Reproductive Health (ANSIRH)\'s Abortion Facility Database, which includes data on all publicly advertising abortion facilities and is updated annually. We describe facility out-of-pocket prices for medication abortion in 2021, 2022, and 2023, comparing in-person and telehealth provided by brick-and-mortar and virtual clinics, and by whether states allowed Medicaid coverage for abortion.
RESULTS: The national median price for medication abortion remained consistent at $568 in 2021 and $563 in 2023. However, medications provided by virtual clinics were notably lower in price than in-person care and this difference widened over time. The median cost of a medication abortion offered in-person increased from $580 in 2021 to $600 by 2023, while the median price of a medication abortion offered by virtual clinics decreased from $239 in 2021 to $150 in 2023. Among virtual clinics, few (7%) accepted Medicaid. Median prices in states that accept Medicaid were generally higher than in states that did not.
CONCLUSIONS: Medication abortion is offered at substantially lower prices by virtual clinics. However, not being able to use Medicaid or other insurance may make telehealth cost-prohibitive for some people, even if prices are lower. Additionally, many states do not allow telehealth for abortion, deepening inequities in healthcare.
METHODS: We used Advancing New Standards in Reproductive Health (ANSIRH)\'s Abortion Facility Database, which includes data on all publicly advertising abortion facilities and is updated annually. We describe facility out-of-pocket prices for medication abortion in 2021, 2022, and 2023, comparing in-person and telehealth provided by brick-and-mortar and virtual clinics, and by whether states allowed Medicaid coverage for abortion.
RESULTS: The national median price for medication abortion remained consistent at $568 in 2021 and $563 in 2023. However, medications provided by virtual clinics were notably lower in price than in-person care and this difference widened over time. The median cost of a medication abortion offered in-person increased from $580 in 2021 to $600 by 2023, while the median price of a medication abortion offered by virtual clinics decreased from $239 in 2021 to $150 in 2023. Among virtual clinics, few (7%) accepted Medicaid. Median prices in states that accept Medicaid were generally higher than in states that did not.
CONCLUSIONS: Medication abortion is offered at substantially lower prices by virtual clinics. However, not being able to use Medicaid or other insurance may make telehealth cost-prohibitive for some people, even if prices are lower. Additionally, many states do not allow telehealth for abortion, deepening inequities in healthcare.
摘要：
背景：财务成本仍然是堕胎的最大障碍之一，导致护理延误，并阻止一些人获得所需的堕胎。药物流产可通过当面设施和远程保健服务获得。然而,远程医疗是否提供更实惠的选择还没有得到充分的记录。
方法：我们使用了推进生殖健康新标准（ANSIRH）的堕胎设施数据库，其中包括所有公开广告堕胎设施的数据，并每年更新。我们描述了2021年、2022年和2023年药物流产的设施自付价格，比较了实体诊所和虚拟诊所提供的面对面和远程医疗，以及各州是否允许医疗补助覆盖堕胎。
结果：药物流产的全国中位数价格在2021年和2023年保持一致，分别为568美元和563美元。然而,虚拟诊所提供的药物在价格上明显低于现场护理，而且这种差异随着时间的推移而扩大。亲自提供的药物流产的中位数成本从2021年的580美元增加到2023年的600美元，而虚拟诊所提供的药物流产的中位数价格从2021年的239美元下降到2023年的150美元。在虚拟诊所中，很少（7％）接受医疗补助。接受医疗补助的州的中位数价格通常高于不接受医疗补助的州。
结论：虚拟诊所以更低的价格提供药物流产。然而,无法使用医疗补助或其他保险可能会使某些人的远程医疗成本过高，即使价格更低。此外,许多州不允许远程医疗堕胎，深化医疗保健领域的不平等。
方法：我们使用了推进生殖健康新标准（ANSIRH）的堕胎设施数据库，其中包括所有公开广告堕胎设施的数据，并每年更新。我们描述了2021年、2022年和2023年药物流产的设施自付价格，比较了实体诊所和虚拟诊所提供的面对面和远程医疗，以及各州是否允许医疗补助覆盖堕胎。
结果：药物流产的全国中位数价格在2021年和2023年保持一致，分别为568美元和563美元。然而,虚拟诊所提供的药物在价格上明显低于现场护理，而且这种差异随着时间的推移而扩大。亲自提供的药物流产的中位数成本从2021年的580美元增加到2023年的600美元，而虚拟诊所提供的药物流产的中位数价格从2021年的239美元下降到2023年的150美元。在虚拟诊所中，很少（7％）接受医疗补助。接受医疗补助的州的中位数价格通常高于不接受医疗补助的州。
结论：虚拟诊所以更低的价格提供药物流产。然而,无法使用医疗补助或其他保险可能会使某些人的远程医疗成本过高，即使价格更低。此外,许多州不允许远程医疗堕胎，深化医疗保健领域的不平等。
