Access to assisted reproductive technology centers in the United States
Received 9 July 2008; received in revised form 15 October 2008; accepted 17 October 2008. published online 10 December 2008.
Objective
To describe the disparity of assisted reproductive technology (ART) centers in the United States as they relate to residential locations of populations in their reproductive years and state-mandated coverage for infertility services.
Design
Cross-sectional study.
Setting
Population in reproductive years (women 20–44 years; men 20–49 years) based on US Census 2000 data. Assisted reproductive technology centers registered with the Society for Assisted Reproductive Technology (SART) in 2005.
Main Outcome Measure(s)
Populations within service area served by in-state and neighboring state ART centers as defined by a 60-minute travel time along road networks from each center.
Result(s)
Service areas for 387 of 390 ART centers were calculated. Fourteen states had some form of mandated coverage. Underserved states included Alaska, Montana, Wyoming, and West Virginia. The northeastern United States had the greatest percentage of overserved population with 66%–100% study population within 60 minutes of an ART center. Female age stratification showed the highest age group (35–44 years) per state in northern New England and the youngest in Utah and District of Columbia. Median total study population within 60 minutes of an ART center in their own state was higher in mandated versus nonmandated states.
Conclusion(s)
Disparity of access to care for infertility services exists from the standpoint of population service areas for ART centers and state-mandated coverage. Female age stratification may help anticipate future need for services with existing resource distribution.
aSection of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
bDepartment of Surgery, Dartmouth Medical School, Hanover, New Hampshire
cThe Dartmouth Institute for Health Policy and Clinical Practice, and Community & Family Medicine, Dartmouth Medical School, Hanover, New Hampshire
Reprint requests: Ajay K. Nangia, M.B.B.S., F.A.C.S., Dept. of Urology, MS3016, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160 (FAX: 913-588-7625).
A.K.N. has nothing to disclose. D.S.L. has nothing to disclose. D.W. has nothing to disclose.
Supported by an academic grant, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
ABSTRACT