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Cost and complications of abortion in ambulatory surgery centers vs. offices/clinics

Sarah Roberts, University of California, San Francisco

Project abstract

State-level targeted regulation of abortion provider (TRAP) laws in 22 states have onerous licensing standards for abortion facilities, many of which are comparable or equivalent to the state's licensing standards for ambulatory surgery centers (ASCs). Supporters of ASC laws argue, without supporting evidence, that ASC requirements make abortion safer. Opponents of ASC laws argue, with supporting evidence, that abortion in offices/clinics is safe and so ASC requirements are not needed. Opponents of ASC laws also note that the cost of ASC requirements drastically reduces abortion access through clinic closures. Despite these laws and public debate about these laws, no published study has directly compared the safety or cost of abortion in ASCs to abortion in offices/clinics. This project proposes to use a national insurance claims database (Truven Health MarketScan®) of approximately 50 million privately-insured patients to examine 1) whether risk of complications differs for abortions in ASCs vs. offices/clinics, and 2) whether the cost of abortion differs in ASCs vs. offices/clinics. Our findings will contribute evidence to inform policy on abortion facility standards, assist health departments as they write regulations for abortion facilities, and support public education on the topic.

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