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Impact of Health Insurance Type on Trends in Newborn Circumcision, United States, 2000 to 2010.
Am J Public Health. 2015 Sep; 105(9):1943-9.AJ

Abstract

OBJECTIVES

We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision.

METHODS

Hospital discharge data from the 2000-2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact of insurance coverage on circumcision incidence.

RESULTS

Overall, circumcision incidence decreased significantly from 61.3% in 2000 to 56.9% in 2010 in unadjusted analyses (P for trend = .008), but not in analyses adjusted for insurance status (P for trend = .46) and other predictors (P for trend = .55). Significant decreases were observed only in the South, where adjusted analyses revealed decreases in circumcision overall (P for trend = .007) and among hospitalizations with Medicaid (P for trend = .005) but not those with private insurance (P for trend = .13). Newborn male birth hospitalizations covered by Medicaid increased from 36.0% (2000) to 50.1% (2010; P for trend < .001), suggesting 390,000 additional circumcisions might have occurred nationwide had insurance coverage remained constant.

CONCLUSIONS

Shifts in insurance coverage, particularly toward Medicaid, likely contributed to decreases in newborn circumcision nationwide and in the South. Barriers to the availability of circumcision should be revisited, particularly for families who desire but have less financial access to the procedure.

Authors+Show Affiliations

All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.All of the authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26180994

Citation

Warner, Lee, et al. "Impact of Health Insurance Type On Trends in Newborn Circumcision, United States, 2000 to 2010." American Journal of Public Health, vol. 105, no. 9, 2015, pp. 1943-9.
Warner L, Cox S, Whiteman M, et al. Impact of Health Insurance Type on Trends in Newborn Circumcision, United States, 2000 to 2010. Am J Public Health. 2015;105(9):1943-9.
Warner, L., Cox, S., Whiteman, M., Jamieson, D. J., Macaluso, M., Bansil, P., Kuklina, E., Kourtis, A. P., Posner, S., & Barfield, W. D. (2015). Impact of Health Insurance Type on Trends in Newborn Circumcision, United States, 2000 to 2010. American Journal of Public Health, 105(9), 1943-9. https://doi.org/10.2105/AJPH.2015.302629
Warner L, et al. Impact of Health Insurance Type On Trends in Newborn Circumcision, United States, 2000 to 2010. Am J Public Health. 2015;105(9):1943-9. PubMed PMID: 26180994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Health Insurance Type on Trends in Newborn Circumcision, United States, 2000 to 2010. AU - Warner,Lee, AU - Cox,Shanna, AU - Whiteman,Maura, AU - Jamieson,Denise J, AU - Macaluso,Maurizio, AU - Bansil,Pooja, AU - Kuklina,Elena, AU - Kourtis,Athena P, AU - Posner,Samuel, AU - Barfield,Wanda D, Y1 - 2015/07/16/ PY - 2015/7/17/entrez PY - 2015/7/17/pubmed PY - 2015/10/31/medline SP - 1943 EP - 9 JF - American journal of public health JO - Am J Public Health VL - 105 IS - 9 N2 - OBJECTIVES: We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision. METHODS: Hospital discharge data from the 2000-2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact of insurance coverage on circumcision incidence. RESULTS: Overall, circumcision incidence decreased significantly from 61.3% in 2000 to 56.9% in 2010 in unadjusted analyses (P for trend = .008), but not in analyses adjusted for insurance status (P for trend = .46) and other predictors (P for trend = .55). Significant decreases were observed only in the South, where adjusted analyses revealed decreases in circumcision overall (P for trend = .007) and among hospitalizations with Medicaid (P for trend = .005) but not those with private insurance (P for trend = .13). Newborn male birth hospitalizations covered by Medicaid increased from 36.0% (2000) to 50.1% (2010; P for trend < .001), suggesting 390,000 additional circumcisions might have occurred nationwide had insurance coverage remained constant. CONCLUSIONS: Shifts in insurance coverage, particularly toward Medicaid, likely contributed to decreases in newborn circumcision nationwide and in the South. Barriers to the availability of circumcision should be revisited, particularly for families who desire but have less financial access to the procedure. SN - 1541-0048 UR - https://www.unboundmedicine.com/medline/citation/26180994/Impact_of_Health_Insurance_Type_on_Trends_in_Newborn_Circumcision_United_States_2000_to_2010_ L2 - https://www.ajph.org/doi/10.2105/AJPH.2015.302629?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -