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Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States.
Public Health Rep. 2021 May; 136(3):338-344.PH

Abstract

OBJECTIVES

Male circumcision is linked to a reduction in the risk of HIV infection, sexually transmitted infections, penile inflammatory skin disorders, cancers, urinary tract infections, and other complications. We examined the extent to which the change in circumcision recommendation by the American Academy of Pediatrics in 1999 and Medicaid coverage status in states affected the total number of procedures performed.

METHODS

We used data from the Nationwide Inpatient Sample for 1998-2011 collected annually by the Healthcare Cost and Utilization Project. We examined data on all male births in the United States with Medicaid and private health insurance. We then categorized births into 4 groups: (1) births with newborn male circumcision procedure, (2) births with Medicaid or private health insurance, (3) births that occurred in states where Medicaid coverage for newborn male circumcision was removed, and (4) births that occurred before or after the policy change. We used multivariable logistic regression to estimate the adjusted odds of newborn male circumcision.

RESULTS

In the 10 states where a change in Medicaid policy occurred, circumcision frequency had a mean percentage-point decrease of 21.4% among Medicaid beneficiaries and 3.2% among private health insurance beneficiaries from before to after the policy change. In states where coverage was maintained, the change in circumcision frequency was negligible for Medicaid and private health insurance beneficiaries. These changes resulted in an estimated 163 456 potential circumcisions not performed.

CONCLUSION

Decreases in newborn male circumcision frequency correlated with the Medicaid policy change for the procedure. Efforts should be made to reduce barriers for cost-effective preventive procedures that promote health, such as newborn male circumcision.

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Authors+Show Affiliations

Torosian T
Bowman Gray Center for Medical Education, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Quint JJ
12222 Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Klausner JD
12222 Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. 12222 Department of Medicine, Division of Infectious Diseases: Global Health, University of California, Los Angeles, Los Angeles, CA, USA.

MeSH

Circumcision, MaleForecastingHumansInfant, NewbornInsurance CoverageMaleMedicaidState GovernmentUnited States

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

33440128

Citation

Torosian, Taron, et al. "Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States." Public Health Reports (Washington, D.C. : 1974), vol. 136, no. 3, 2021, pp. 338-344.
Torosian T, Quint JJ, Klausner JD. Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States. Public Health Rep. 2021;136(3):338-344.
Torosian, T., Quint, J. J., & Klausner, J. D. (2021). Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States. Public Health Reports (Washington, D.C. : 1974), 136(3), 338-344. https://doi.org/10.1177/0033354920971719
Torosian T, Quint JJ, Klausner JD. Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States. Public Health Rep. 2021;136(3):338-344. PubMed PMID: 33440128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decline in Frequency of Newborn Male Circumcision After Change in Medicaid Coverage Status in Selected States in the United States. AU - Torosian,Taron, AU - Quint,Joshua J, AU - Klausner,Jeffrey D, Y1 - 2021/01/13/ PY - 2021/1/14/pubmed PY - 2021/8/31/medline PY - 2021/1/13/entrez KW - infectious diseases KW - newborn male circumcision KW - policy changes SP - 338 EP - 344 JF - Public health reports (Washington, D.C. : 1974) JO - Public Health Rep VL - 136 IS - 3 N2 - OBJECTIVES: Male circumcision is linked to a reduction in the risk of HIV infection, sexually transmitted infections, penile inflammatory skin disorders, cancers, urinary tract infections, and other complications. We examined the extent to which the change in circumcision recommendation by the American Academy of Pediatrics in 1999 and Medicaid coverage status in states affected the total number of procedures performed. METHODS: We used data from the Nationwide Inpatient Sample for 1998-2011 collected annually by the Healthcare Cost and Utilization Project. We examined data on all male births in the United States with Medicaid and private health insurance. We then categorized births into 4 groups: (1) births with newborn male circumcision procedure, (2) births with Medicaid or private health insurance, (3) births that occurred in states where Medicaid coverage for newborn male circumcision was removed, and (4) births that occurred before or after the policy change. We used multivariable logistic regression to estimate the adjusted odds of newborn male circumcision. RESULTS: In the 10 states where a change in Medicaid policy occurred, circumcision frequency had a mean percentage-point decrease of 21.4% among Medicaid beneficiaries and 3.2% among private health insurance beneficiaries from before to after the policy change. In states where coverage was maintained, the change in circumcision frequency was negligible for Medicaid and private health insurance beneficiaries. These changes resulted in an estimated 163 456 potential circumcisions not performed. CONCLUSION: Decreases in newborn male circumcision frequency correlated with the Medicaid policy change for the procedure. Efforts should be made to reduce barriers for cost-effective preventive procedures that promote health, such as newborn male circumcision. SN - 1468-2877 UR - https://www.unboundmedicine.com/medline/citation/33440128/Decline_in_Frequency_of_Newborn_Male_Circumcision_After_Change_in_Medicaid_Coverage_Status_in_Selected_States_in_the_United_States_ DB - PRIME DP - Unbound Medicine ER -