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Luisa Franzini, PhD; Elena Marks, JD, MPH; Polly F. Cromwell, RN, MSN, CPNP; Jan Risser, PhD; Laurie McGill, MPH; Christine Markham, PhD; Beatrice Selwyn, ScD; Carrie Shapiro, MPH

Arch Pediatr Adolesc Med. 2004;158:1140-1146.

Background  We wanted to focus on the potential consequences of recently enacted legislation in Texas that limits adolescents’ ability to obtain confidential reproductive health care services.

Objective  To assess the potential economic costs that result when adolescents do not seek reproductive health care services because their confidentiality is compromised.

Design  We developed a cost model to estimate the projected costs of parental consent and law enforcement reporting requirements based on data from the literature, the Texas Department of Health, and publicly funded family planning clinics in Texas. Univariate and multivariate sensitivity analyses explored different scenarios.

Setting  The state of Texas.

Participants  Projected costs were estimated for all girls younger than 18 years using publicly funded reproductive health care services in Texas.

Main Outcome Measures  We determined the projected number of additional pregnancies, births, abortions, and untreated sexually transmitted infections and resulting pelvic inflammatory disease and calculated the associated economic costs of these projected outcomes.

Results  The potential costs of parental consent and law enforcement reporting requirements in Texas were estimated at $43.6 million (range, $11.8 million to $56.6 million) for girls younger than 18 years currently using publicly funded services.

Conclusions  As policymakers throughout the United States search for ways to curtail adolescent sexual activity and its adverse consequences, this analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences.

Author Affiliations: School of Public Health (Drs Franzini, Risser, Markham, and Selwyn and Ms Shapiro) and Department of Pediatrics, Medical School (Ms Cromwell), The University of Texas Health Science Center at Houston and Planned Parenthood of Houston and Southeast Texas (Mss Marks and McGill).

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ABSTRACT  

Measuring Public Costs Associated With Loss of Confidentiality for Adolescents Seeking Confidential Reproductive Health Care: How High the Costs? How Heavy the Burden?
Brindis and English
Arch Pediatr Adolesc Med 2004;158:1182-1184.
FULL TEXT