TY  - JOUR
AU  - Congy, Juliette
AU  - Rahib, Delphine
AU  - Leroy, Céline
AU  - Bouyer, Jean
AU  - de La Rochebrochard, Elise
PY  - 2024
DA  - 2024/7/22
TI  - Contraceptive Use Measured in a National Population–Based Approach: Cross-Sectional Study of Administrative Versus Survey Data
JO  - JMIR Public Health Surveill
SP  - e45030
VL  - 10
KW  - contraception
KW  - administrative data
KW  - health data
KW  - implant
KW  - oral contraceptives
KW  - intrauterine device
KW  - IUD
KW  - contraceptive prevalence
KW  - contraceptive
KW  - birth control
KW  - monitoring
KW  - public health issue
KW  - population-based survey
KW  - prevalence
AB  - Background: Prescribed contraception is used worldwide by over 400 million women of reproductive age. Monitoring contraceptive use is a major public health issue that usually relies on population-based surveys. However, these surveys are conducted on average every 6 years and do not allow close follow-up of contraceptive use. Moreover, their sample size is often too limited for the study of specific population subgroups such as people with low income. Health administrative data could be an innovative and less costly source to study contraceptive use. Objective: We aimed to explore the potential of health administrative data to study prescribed contraceptive use and compare these data with observations based on survey data. Methods: We selected all women aged 15-49 years, covered by French health insurance and living in France, in the health administrative database, which covers 98% of the resident population (n=14,788,124), and in the last French population–based representative survey, the Health Barometer Survey, conducted in 2016 (n=4285). In health administrative data, contraceptive use was recorded with detailed information on the product delivered, whereas in the survey, it was self-declared by the women. In both sources, the prevalence of contraceptive use was estimated globally for all prescribed contraceptives and by type of contraceptive: oral contraceptives, intrauterine devices (IUDs), and implants. Prevalences were analyzed by age. Results: There were more low-income women in health administrative data than in the population-based survey (1,576,066/14,770,256, 11% vs 188/4285, 7%, respectively; P<.001). In health administrative data, 47.6% (7034,710/14,770,256; 95% CI 47.6%-47.7%) of women aged 15-49 years used a prescribed contraceptive versus 50.5% (2297/4285; 95% CI 49.1%-52.0%) in the population-based survey. Considering prevalences by the type of contraceptive in health administrative data versus survey data, they were 26.9% (95% CI 26.9%-26.9%) versus 27.7% (95% CI 26.4%-29.0%) for oral contraceptives, 17.7% (95% CI 17.7%-17.8%) versus 19.6% (95% CI 18.5%-20.8%) for IUDs, and 3% (95% CI 3.0%-3.0%) versus 3.2% (95% CI 2.7%-3.7%) for implants. In both sources, the same overall tendency in prevalence was observed for these 3 contraceptives. Implants remained little used at all ages, oral contraceptives were highly used among young women, whereas IUD use was low among young women. Conclusions: Compared with survey data, health administrative data exhibited the same overall tendencies for oral contraceptives, IUDs, and implants. One of the main strengths of health administrative data is the high quality of information on contraceptive use and the large number of observations, allowing studies of subgroups of population. Health administrative data therefore appear as a promising new source to monitor contraception in a population-based approach. They could open new perspectives for research and be a valuable new asset to guide public policies on reproductive and sexual health. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e45030
UR  - https://doi.org/10.2196/45030
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39037774
DO  - 10.2196/45030
ID  - info:doi/10.2196/45030
ER  -