TEXAS: Docs See Costs in Limiting Teens' Confidentiality

Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.

TEXAS: Docs See Costs in Limiting Teens' Confidentiality

Reuters (12.07.04) - Monday, December 20, 2004

Recently passed legislation in Texas that limits teenagers' ability to obtain confidential reproductive health-care services could have serious economic and health consequences, according to new research. Although the law aims to curtail adolescent sexual activity, teens will likely remain sexually active but forgo using those services, the report says.

Under the law, parental consent is required for girls under age 18 to receive prescription contraceptives, explained Dr. Luisa Franzini, of the University of Texas School of Public Health, and colleagues. The law also requires health care providers to report patients under age 17 to law enforcement officials, as it is a criminal offense to have sexual contact with persons this young.

The UT researchers estimated the cost of these requirements based on the projected number of untreated STDs and additional pregnancies, births and abortions. Based on past surveys of what girls said they would do if confidentiality were not maintained, they estimated that 37 percent of girls would stop using reproductive health-care services if parental notification were required.

As a result, there would be an additional 11.45 pregnancies, 7.44 births and 2.29 abortions per 100 teenagers, with an approximate cost of $61,000 per 100 girls. In addition, the estimated increases in STDs would cost $980 per 100 teens. The researchers reported the projected overall cost at around $43.6 million per year. However, that figure underestimates "the true costs to society because they include only direct medical costs," they added.

In an editorial accompanying the report, Dr. Claire C. Brindis and Abigail English at the University of California-San Francisco noted several other states and the federal government are currently considering similar legislation. "Will public policy makers seriously consider the potential negative physical, psychological, and cost-related outcomes for adolescents and the health of the public their policies may cause?" they asked. "Perhaps they, and the adolescents and families they are accountable to, would be better served if they followed the edict of medicine, 'First do no harm.'"

The report, "Projected Economic Costs Due to Health Consequences of Teenagers' Loss of Confidentiality in Obtaining Reproductive Health Care Services in Texas," and the editorial "Measuring Public Costs Associated with Loss of Confidentiality for Adolescents Seeking Confidential Reproductive Health Care," were published in the Archives of Pediatrics & Adolescent Medicine (2004;158(12):1140-1146 and 1182-1184, respectively).
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