Visits to Registered Nurses: An Opportunity to Increase Contraceptive Access in California

Emese C. Parker, Kevin Kong, Leslie A. Watts, Eleanor Schwarz, Philip D. Darney, Heike Thiel De Bocanegra

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. Aims The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). Methods A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. Results RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the subsequent 30 days. Discussion RN visits, though underutilized across the state, have resulted in increased access to contraception in some communities, an effect that may continue to grow with time and can serve as a model for other states.

Original languageEnglish (US)
Pages (from-to)286-294
Number of pages9
JournalNursing Research
Volume66
Issue number4
DOIs
StatePublished - Jul 1 2017

Fingerprint

Contraceptive Agents
Nurses
Contraception
Family Planning Services
Healthcare Common Procedure Coding System
Delivery of Health Care
Nurse Midwives
Physician Assistants
Nurse Practitioners
Terminology
Therapeutics
Databases
Physicians
Costs and Cost Analysis
Injections

Keywords

  • California
  • contraception
  • nursing
  • public policy

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Visits to Registered Nurses : An Opportunity to Increase Contraceptive Access in California. / Parker, Emese C.; Kong, Kevin; Watts, Leslie A.; Schwarz, Eleanor; Darney, Philip D.; Thiel De Bocanegra, Heike.

In: Nursing Research, Vol. 66, No. 4, 01.07.2017, p. 286-294.

Research output: Contribution to journalArticle

Parker, EC, Kong, K, Watts, LA, Schwarz, E, Darney, PD & Thiel De Bocanegra, H 2017, 'Visits to Registered Nurses: An Opportunity to Increase Contraceptive Access in California', Nursing Research, vol. 66, no. 4, pp. 286-294. https://doi.org/10.1097/NNR.0000000000000229
Parker, Emese C. ; Kong, Kevin ; Watts, Leslie A. ; Schwarz, Eleanor ; Darney, Philip D. ; Thiel De Bocanegra, Heike. / Visits to Registered Nurses : An Opportunity to Increase Contraceptive Access in California. In: Nursing Research. 2017 ; Vol. 66, No. 4. pp. 286-294.
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abstract = "Background In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. Aims The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). Methods A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. Results RN visits were found mainly in Northern California and the Central Valley (73{\%}). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10{\%} increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the subsequent 30 days. Discussion RN visits, though underutilized across the state, have resulted in increased access to contraception in some communities, an effect that may continue to grow with time and can serve as a model for other states.",
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