Revolving Loan Fund: A Novel Approach to Increasing Access to LARC Methods [5N]

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Abstract

INTRODUCTION:

A survey of family planning departments in Boston community health centers indicated difficulty purchasing and maintaining Long Acting Reversible Contraception (LARC) supplies, resulting in longer wait times and decreased access.

METHODS:

Three pilot sites were identified to implement a revolving loan fund (RLF). Each clinic received $4,800 from the RLF to purchase LARC devices. Data was collected through chart review retrospectively one year prior to start of the RLF and prospectively one year. Data collected included patient demographics, type of LARC selected, patient's date of documented interest in a LARC device, and date of insertion. The effect of RLF on delay to LARC insertion was tested using negative binomial regression, controlling for confounding variables between the pre- and post-RLF periods.

RESULTS:

Data on 133 patients in the pre-RLF group and 205 in the post-RLF group was collected. There were no statistically significant differences in demographic or clinical characteristics between the two time periods. LARC uptake increased significantly from pre- and post-RLF groups (P=.0265), specifically among implant users. There was a statistically significant decrease in the mean number of days in delay from interest to insertion from pre- and post-RLF groups (pre-RLF: 31.3±50.6 days; post-RLF: 13.6±16.7 days, adjusted P less than .0001). The reasons for the delay (patient or clinic error) did not differ significantly between the two time periods.

CONCLUSION:

The RLF decreased wait time for the devices and increased overall insertion rates. This may serve as a promising solution to improve LARC access in community health centers.

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