PDF(Pubmed)
Abstract：
BACKGROUND: Telehealth abortion has taken on a vital role in maintaining abortion access since the Dobbs v. Jackson Women\'s Health Organization Supreme Court decision. However, little remains known about the landscape of new telehealth-only virtual clinic abortion providers that have expanded since telehealth abortion first became widely available in the United States in 2021.
OBJECTIVE: This study aimed to (1) document the landscape of telehealth-only virtual clinic abortion care in the United States, (2) describe changes in the presence of virtual clinic abortion services between September 2022, following the Dobbs decision, and June 2023, and (3) identify structural factors that may perpetuate inequities in access to virtual clinic abortion care.
METHODS: We conducted a repeated cross-sectional study by reviewing web search results and abortion directories to identify virtual abortion clinics in September 2022 and June 2023 and described changes in the presence of virtual clinics between these 2 periods. In June 2023, we also described each virtual clinic\'s policies, including states served, costs, patient age limits, insurance acceptance, financial assistance available, and gestational limits.
RESULTS: We documented 11 virtual clinics providing telehealth abortion care in 26 states and Washington DC in September 2022. By June 2023, 20 virtual clinics were providing services in 27 states and Washington DC. Most (n=16) offered care to minors, 8 provided care until 10 weeks of pregnancy, and median costs were US $259. In addition, 2 accepted private insurance and 1 accepted Medicaid, within a limited number of states. Most (n=16) had some form of financial assistance available.
CONCLUSIONS: Virtual clinic abortion providers have proliferated since the Dobbs decision. We documented inequities in the availability of telehealth abortion care from virtual clinics, including age restrictions that exclude minors, gestational limits for care, and limited insurance and Medicaid acceptance. Notably, virtual clinic abortion care was not permitted in 11 states where in-person abortion is available.
OBJECTIVE: This study aimed to (1) document the landscape of telehealth-only virtual clinic abortion care in the United States, (2) describe changes in the presence of virtual clinic abortion services between September 2022, following the Dobbs decision, and June 2023, and (3) identify structural factors that may perpetuate inequities in access to virtual clinic abortion care.
METHODS: We conducted a repeated cross-sectional study by reviewing web search results and abortion directories to identify virtual abortion clinics in September 2022 and June 2023 and described changes in the presence of virtual clinics between these 2 periods. In June 2023, we also described each virtual clinic\'s policies, including states served, costs, patient age limits, insurance acceptance, financial assistance available, and gestational limits.
RESULTS: We documented 11 virtual clinics providing telehealth abortion care in 26 states and Washington DC in September 2022. By June 2023, 20 virtual clinics were providing services in 27 states and Washington DC. Most (n=16) offered care to minors, 8 provided care until 10 weeks of pregnancy, and median costs were US $259. In addition, 2 accepted private insurance and 1 accepted Medicaid, within a limited number of states. Most (n=16) had some form of financial assistance available.
CONCLUSIONS: Virtual clinic abortion providers have proliferated since the Dobbs decision. We documented inequities in the availability of telehealth abortion care from virtual clinics, including age restrictions that exclude minors, gestational limits for care, and limited insurance and Medicaid acceptance. Notably, virtual clinic abortion care was not permitted in 11 states where in-person abortion is available.
摘要：
背景：自Dobbs诉Jackson妇女保健组织最高法院的判决以来，远程保健堕胎在维持堕胎准入方面发挥了至关重要的作用。然而,自2021年远程医疗堕胎首次在美国广泛使用以来，新的仅远程医疗虚拟诊所堕胎提供者的前景知之甚少。
目的：这项研究旨在（1）记录美国仅远程医疗虚拟诊所堕胎护理的情况，（2）描述在Dobbs决定之后，2022年9月之间虚拟诊所堕胎服务的存在变化，和2023年6月，以及（3）确定可能使虚拟诊所堕胎护理的不平等现象长期存在的结构性因素。
方法：我们通过回顾网络搜索结果和堕胎目录进行了重复的横断面研究，以确定2022年9月和2023年6月的虚拟堕胎诊所，并描述了这两个时期之间虚拟诊所的存在变化。2023年6月，我们还描述了每个虚拟诊所的政策，包括服务的州，成本,患者年龄限制,保险承兑，财政援助可用，和妊娠限制。
结果：我们记录了2022年9月在26个州和华盛顿特区提供远程健康堕胎护理的11个虚拟诊所。到2023年6月，有20个虚拟诊所在27个州和华盛顿特区提供服务。大多数（n=16）为未成年人提供护理，8提供护理，直到怀孕10周，中位数成本为259美元。此外,2个接受私人保险和1个接受医疗补助，在有限数量的州内。大多数（n=16）都有某种形式的财政援助。
结论：自Dobbs决定以来，虚拟诊所堕胎提供者激增。我们记录了虚拟诊所提供远程健康堕胎护理的不平等，包括排除未成年人的年龄限制，妊娠护理限制，以及有限的保险和医疗补助接受。值得注意的是,在11个州不允许虚拟诊所堕胎护理。
目的：这项研究旨在（1）记录美国仅远程医疗虚拟诊所堕胎护理的情况，（2）描述在Dobbs决定之后，2022年9月之间虚拟诊所堕胎服务的存在变化，和2023年6月，以及（3）确定可能使虚拟诊所堕胎护理的不平等现象长期存在的结构性因素。
方法：我们通过回顾网络搜索结果和堕胎目录进行了重复的横断面研究，以确定2022年9月和2023年6月的虚拟堕胎诊所，并描述了这两个时期之间虚拟诊所的存在变化。2023年6月，我们还描述了每个虚拟诊所的政策，包括服务的州，成本,患者年龄限制,保险承兑，财政援助可用，和妊娠限制。
结果：我们记录了2022年9月在26个州和华盛顿特区提供远程健康堕胎护理的11个虚拟诊所。到2023年6月，有20个虚拟诊所在27个州和华盛顿特区提供服务。大多数（n=16）为未成年人提供护理，8提供护理，直到怀孕10周，中位数成本为259美元。此外,2个接受私人保险和1个接受医疗补助，在有限数量的州内。大多数（n=16）都有某种形式的财政援助。
结论：自Dobbs决定以来，虚拟诊所堕胎提供者激增。我们记录了虚拟诊所提供远程健康堕胎护理的不平等，包括排除未成年人的年龄限制，妊娠护理限制，以及有限的保险和医疗补助接受。值得注意的是,在11个州不允许虚拟诊所堕胎护理。
