title: Projected economic costs due to health consequences of teenagers' loss of confidentiality in obtaining reproductive health care services in Texas.
abstract: BACKGROUND
  We wanted to focus on the potential consequences of recently enacted legislation in Texas that limits adolescents' ability to obtain confidential reproductive health care services.
  
  
  OBJECTIVE
  To assess the potential economic costs that result when adolescents do not seek reproductive health care services because their confidentiality is compromised.
  
  
  METHODS
  We developed a cost model to estimate the projected costs of parental consent and law enforcement reporting requirements based on data from the literature, the Texas Department of Health, and publicly funded family planning clinics in Texas. Univariate and multivariate sensitivity analyses explored different scenarios.
  
  
  METHODS
  The state of Texas.
  
  
  METHODS
  Projected costs were estimated for all girls younger than 18 years using publicly funded reproductive health care services in Texas.
  
  
  METHODS
  We determined the projected number of additional pregnancies, births, abortions, and untreated sexually transmitted infections and resulting pelvic inflammatory disease and calculated the associated economic costs of these projected outcomes.
  
  
  RESULTS
  The potential costs of parental consent and law enforcement reporting requirements in Texas were estimated at 43.6 million dollars (range, 11.8 million dollars to 56.6 million dollars) for girls younger than 18 years currently using publicly funded services.
  
  
  CONCLUSIONS
  As policymakers throughout the United States search for ways to curtail adolescent sexual activity and its adverse consequences, this analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences.
authors.affiliation: School of Public Health, The University of Texas Health Science Center at Houston, 77030, USA. lfranzini@sph.uth.tmc.edu
authors.forename: Luisa
authors.initials: L
authors.lastname: Franzini
authors.forename: Elena
authors.initials: E
authors.lastname: Marks
authors.forename: Polly F
authors.initials: PF
authors.lastname: Cromwell
authors.forename: Jan
authors.initials: J
authors.lastname: Risser
authors.forename: Laurie
authors.initials: L
authors.lastname: McGill
authors.forename: Christine
authors.initials: C
authors.lastname: Markham
authors.forename: Beatrice
authors.initials: B
authors.lastname: Selwyn
authors.forename: Carrie
authors.initials: C
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000191:economics / Q000331:legislation & jurisprudence*; D003219:Confidentiality; D005260:Female; D005380:Financing, Government / Q000191:economics; D006801:Humans; D033282:Parental Consent / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D034121:Reproductive Health Services / Q000191:economics* / Q000331:legislation & jurisprudence; D012749:Sexually Transmitted Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D013781:Texas / Q000453:epidemiology