title: Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden.
abstract: BACKGROUND
  Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark.
  
  
  METHODS
  Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T.
  
  
  RESULTS
  No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden.
  
  
  CONCLUSIONS
  Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies.
authors.forename: Adam
authors.initials: A
authors.lastname: Sydsjö
authors.forename: Gunilla
authors.initials: G
authors.lastname: Sydsjö
authors.forename: Marie
authors.initials: M
authors.lastname: Bladh
authors.affiliation: Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden. ann.josefsson@lio.se.
authors.forename: Ann
authors.initials: A
authors.lastname: Josefsson
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D003270:Contraceptive Agents / Q000191:economics*; D005193:Family Planning Services; D005260:Female; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012051:Reimbursement Mechanisms; D013548:Sweden / Q000453:epidemiology
chemical_list: D003270:Contraceptive Agents