Changes in insurance status in CHOICE project participants

OBJECTIVE: To evaluate changes in insurance status of the Contraceptive CHOICE Project (CHOICE) participants between enrollment and long-term (5-year) follow-up. STUDY DESIGN: A random sample of 463 CHOICE participants who received an intrauterine device between January 2008 and June 2009 were contacted for a follow-up telephone survey (median follow-up time, 69.6 months). This sub-study compares the insurance statuses at enrollment and at follow-up using a related samples McNemar test. RESULTS: This analysis includes the 311 women who consented to participate in the follow-up survey and provided insurance status information. These women had a mean age of 34 years, 51% were white, and 19% had a household income below 100% of the federal poverty level. We noted a statistically significant change in insurance status over this time period (41% uninsured at time of enrollment, 24% uninsured at time of follow-up; p<0.001). Multinomial analysis showed that a change to full-time employment was associated with gaining insurance (RR=1.97, 95% CI 1.12–3.47). CONCLUSION: Women in this study were more likely to gain insurance than lose insurance between enrollment in CHOICE and at the time of follow-up. Since insurance status is associated with positive health outcomes, this improvement in insurance status is promising.