Dataset Information

Patients' perspectives on allocation of publicly funded in vitro fertilization in Ontario: a qualitative study.

ABSTRACT:

Background

The aim of this study was to determine consumers' perspectives on fair allocation of publicly funded in vitro fertilization (IVF) in the recently implemented Ontario Fertility Program (OFP). The research questions were as follows: 1) What factors do those who require IVF think are important to consider when distributing funded IVF? and 2) What are the barriers to accessing publicly funded IVF?

Methods

We approached this qualitative study with a social constructivist interpretative framework with grounded theory methodology. Data were obtained via focus group. We recruited participants eligible for the OFP from a tertiary care fertility clinic. Two researchers conducted all interviews, independently reviewed the transcriptions and analyzed the data for open coding, followed by axial coding and then selective coding to determine themes.

Results

A total of 13 participants (10 women and 3 men with an average age of 36.4 [range 28-40.7] yr) partook in 4 focus groups. The average duration of infertility was 1.9 (range 0.4-3) years. Three important domains were identified. First, the procedure of distributing funds should be done in a transparent and consistent manner. Second, everyone should have a fair and equal chance to accessing the funds. Participants suggested a combination of first-come, first-served and a scoring system as a method to distribute funds. Lack of communication, associated costs and stress of experiencing infertility were cited as barriers to accessing publicly funded IVF.

Interpretation

Ensuring equal and fair access to funds should be prioritized, and information about the process and distribution method to obtain OFP funding should be clearly provided to patients. Transparency, standardization and better communication should be implemented to uphold procedural justice for patients and reduce emotional stress. The findings may be considered by policy-makers to improve the current OFP and when developing similar programs.

SUBMITTER: Assal A

PROVIDER: S-EPMC6559882 | biostudies-literature | 2019 Apr-Jun

REPOSITORIES: biostudies-literature

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Publications

Patients' perspectives on allocation of publicly funded in vitro fertilization in Ontario: a qualitative study.

Assal Angela A Chauhan Nipa N Shin Eyun-Jung EJ Bowman Kerry K Jones Claire C

CMAJ open 20190401 2

<h4>Background</h4>The aim of this study was to determine consumers' perspectives on fair allocation of publicly funded in vitro fertilization (IVF) in the recently implemented Ontario Fertility Program (OFP). The research questions were as follows: 1) What factors do those who require IVF think are important to consider when distributing funded IVF? and 2) What are the barriers to accessing publicly funded IVF?<h4>Methods</h4>We approached this qualitative study with a social constructivist int ...[more]

PMID: 31186285

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Project description:ObjectivesThis study reports the development and pilot application of the Bariatric Surgery Assessment and Prioritisation Tool (BAPT) for use in a public health system. The BAPT was designed as a patient prioritisation instrument to assess patients with excessive weight and type 2 diabetes suitable for bariatric surgery. We assessed whether the instrument successfully identified those who gained the greatest benefits including weight loss, diabetes remission, reduction in comorbidities, and health-related quality of life (HR-QoL).MethodsThe BAPT instrument was applied to score 292 patients referred for bariatric surgery in Queensland between 2017 and 2020 based on their, body mass index, diabetes status, surgical risk (e.g. pulmonary embolism) and comorbidities (e.g. non-alcoholic steatohepatitis). These data were collected at referral and at 12-months post-surgery for 130 patients and stratified by BAPT scores. Outcomes included clinical and HR-QoL.ResultsPatients' BAPT scores ranged from 12 to 78 (possible range 2-98). Those with higher scores tended to be younger (p < 0.001), have higher BMI (p < 0.001) or require insulin to manage diabetes (p < 0.01). All patients lost similar percentages of body weight (20-25%, p = 0.73) but higher-scoring patients were more likely to discontinue oral diabetes medications (p < 0.001) and the improvement in glycated haemoglobin was four times greater in patients scoring 70-79 points compared to those scoring 20-29 (p < 0.05). Those who scored ≥ 50 on the BAPT were substantially more likely to obtain diabetes remission (57% vs 31%). BAPT scores of 40 and above tended to have greater improvement in HR-QoL.ConclusionsThe BAPT prioritised younger patients with higher BMIs who realised greater improvements in their diabetes after bariatric surgery. Higher-scoring BAPT patients should be prioritised for bariatric surgery as they have a greater likelihood of attaining diabetes remission.

Dataset Information

Patients' perspectives on allocation of publicly funded in vitro fertilization in Ontario: a qualitative study.

Background

Methods

Results

Interpretation

Publications

Patients' perspectives on allocation of publicly funded in vitro fertilization in Ontario: a qualitative study.

Similar Datasets

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