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.
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: Dawn K Smith; Allan Taylor; Peter H Kilmarx; Patrick Sullivan; Lee Warner; Mary Kamb; Naomi Bock; Bos Kohmescher; Timothy D Mastro Journal: Public Health Rep Date: 2010 Jan-Feb Impact factor: 2.792
Authors: Charbel El Bcheraoui; Xinjian Zhang; Christopher S Cooper; Charles E Rose; Peter H Kilmarx; Robert T Chen Journal: JAMA Pediatr Date: 2014-07 Impact factor: 16.193
Authors: Patrick S Sullivan; Peter H Kilmarx; Thomas A Peterman; Allan W Taylor; Allyn K Nakashima; Mary L Kamb; Lee Warner; Timothy D Mastro Journal: PLoS Med Date: 2007-07-24 Impact factor: 11.069
Authors: N Siegfried; M Muller; J Deeks; J Volmink; M Egger; N Low; S Walker; P Williamson Journal: Lancet Infect Dis Date: 2005-03 Impact factor: 25.071
Authors: Brian J Morris; Sean E Kennedy; Alex D Wodak; Adrian Mindel; David Golovsky; Leslie Schrieber; Eugenie R Lumbers; David J Handelsman; John B Ziegler Journal: World J Clin Pediatr Date: 2017-02-08
Authors: Brian J Morris; Richard G Wamai; Esther B Henebeng; Aaron Ar Tobian; Jeffrey D Klausner; Joya Banerjee; Catherine A Hankins Journal: Popul Health Metr Date: 2016-03-01