Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/112610
Título: Assisted reproduction in Spain, outcome and socioeconomic determinants of access
Autores/as: Alon, Ido
Pinilla Domínguez, Jaime 
Clasificación UNESCO: 531207 Sanidad
Palabras clave: Assisted reproductive technology
Bivariate Probit
Competing risk survival analysis
Inequality
Public coverage, et al.
Fecha de publicación: 2021
Proyectos: Encaje Público-Privado en Sanidad: Calidad, Sostenibilidad y Cambios Del Modelo Español 
Publicación seriada: International Journal for Equity in Health 
Resumen: Research question: We analyzed two questions. First, the effectiveness of public Assisted Reproductive Technologies (ART) in Spain compared with private ones, measured by the time since initiating ART treatment until achieving pregnancy, accounting for age and socioeconomic factors. Second, socioeconomic determinants of access to ART, referring primarily to financial means derived by employment, income, and wealth. Design: We applied statistical models on data extracted from the national Spanish Fertility Survey from 2018. The first topic was analyzed by competing risk survival analysis conducted on a sample of 667 women who initiate ART treatment since 2000. The second, by a Bivariate Probit model conducted on a sample of 672 women older than 41 years who required ART services. Results: The first analysis raised that throughout the treatment, patients treated exclusively in private clinics had on average a higher cumulative incidence of becoming pregnant compared with patients who approached public clinics. The second analysis raised that both higher household equivalent income and higher education increase the likelihood of accessing ART in a private clinic and decrease the tendency of accessing public clinics or failing to access any service. Moreover, being single decreases the likelihood of accessing public clinics or ART services in general. Conclusions: Long waiting periods could be the main reason for the lower incidence of getting pregnant in public healthcare, explaining why patients choose private over public care. We develop a broader discussion over the extent of Spanish public funding of ART, the unequal medical outcome, and potential options for optimization.
URI: http://hdl.handle.net/10553/112610
ISSN: 1475-9276
DOI: 10.1186/s12939-021-01438-x
Fuente: International Journal for Equity in Health [ISSN 1475-9276], v. 20, 156 (Julio 2021)
Colección:Artículos
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