{"id":"https://openalex.org/W4409469865","doi":"https://doi.org/10.1111/jog.16292","title":"Impact of insurance coverage on access to assisted reproductive technology: A nationwide survey in Japan (the IZANAMI project)","display_name":"Impact of insurance coverage on access to assisted reproductive technology: A nationwide survey in Japan (the IZANAMI project)","publication_year":2025,"publication_date":"2025-04-01","ids":{"openalex":"https://openalex.org/W4409469865","doi":"https://doi.org/10.1111/jog.16292","pmid":"https://pubmed.ncbi.nlm.nih.gov/40229928","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/11997234"},"language":"en","primary_location":{"id":"doi:10.1111/jog.16292","doi":"https://doi.org/10.1111/jog.16292","is_oa":true,"landing_page_url":"https://doi.org/10.1111/jog.16292","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jog.16292","source":{"id":"https://openalex.org/S4210240629","display_name":"Journal of obstetrics and gynaecology research","issn_l":"1341-8076","issn":["1341-8076","1447-0756"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Obstetrics and Gynaecology Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jog.16292","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Aika Wada","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I203951103","display_name":"Keio University","ror":"https://ror.org/02kn6nx58","country_code":"JP","type":"education","lineage":["https://openalex.org/I203951103"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Aika Wada","raw_affiliation_strings":["Department of Obstetrics and Gynecology Keio University School of Medicine  Tokyo Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology Keio University School of Medicine  Tokyo Japan","institution_ids":["https://openalex.org/I203951103"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048769237","display_name":"Mitsutoshi Yamada","orcid":"https://orcid.org/0000-0002-7560-316X","observed_orcids":["https://orcid.org/0000-0002-7560-316X"]},"institutions":[{"id":"https://openalex.org/I203951103","display_name":"Keio University","ror":"https://ror.org/02kn6nx58","country_code":"JP","type":"education","lineage":["https://openalex.org/I203951103"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Mitsutoshi Yamada","raw_affiliation_strings":["Department of Obstetrics and Gynecology Keio University School of Medicine  Tokyo Japan"],"raw_orcid":"https://orcid.org/0000-0002-7560-316X","affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology Keio University School of Medicine  Tokyo Japan","institution_ids":["https://openalex.org/I203951103"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040475282","display_name":"Hiromitsu Shirasawa","orcid":"https://orcid.org/0000-0001-5300-0037","observed_orcids":["https://orcid.org/0000-0001-5300-0037"]},"institutions":[{"id":"https://openalex.org/I203765153","display_name":"Akita University","ror":"https://ror.org/03hv1ad10","country_code":"JP","type":"education","lineage":["https://openalex.org/I203765153"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Hiromitsu Shirasawa","raw_affiliation_strings":["Department of Obstetrics and Gynecology Akita University Graduate School of Medicine  Akita Japan"],"raw_orcid":"https://orcid.org/0000-0001-5300-0037","affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology Akita University Graduate School of Medicine  Akita Japan","institution_ids":["https://openalex.org/I203765153"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5042166765","display_name":"Seung Chik Jwa","orcid":"https://orcid.org/0000-0002-8815-5714","observed_orcids":["https://orcid.org/0000-0002-8815-5714"]},"institutions":[{"id":"https://openalex.org/I146500386","display_name":"Jichi Medical University","ror":"https://ror.org/010hz0g26","country_code":"JP","type":"education","lineage":["https://openalex.org/I146500386"]},{"id":"https://openalex.org/I4210153031","display_name":"Jichi Medical University Hospital","ror":"https://ror.org/04at0zw32","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210153031"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Seung Chik Jwa","raw_affiliation_strings":["Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"],"raw_orcid":"https://orcid.org/0000-0002-8815-5714","affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan","institution_ids":["https://openalex.org/I146500386","https://openalex.org/I4210153031"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057344007","display_name":"Keiji Kuroda","orcid":"https://orcid.org/0000-0003-2759-9159","observed_orcids":["https://orcid.org/0000-0003-2759-9159"]},"institutions":[{"id":"https://openalex.org/I4405254268","display_name":"Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic","ror":"https://ror.org/01m316d02","country_code":"JP","type":"facility","lineage":["https://openalex.org/I4405254268"]},{"id":"https://openalex.org/I4405265692","display_name":"Sugiyama Clinic Marunouchi","ror":"https://ror.org/05fr1cw47","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4405265692"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Keiji Kuroda","raw_affiliation_strings":["Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi  Tokyo Japan"],"raw_orcid":"https://orcid.org/0000-0003-2759-9159","affiliations":[{"raw_affiliation_string":"Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi  Tokyo Japan","institution_ids":["https://openalex.org/I4405254268","https://openalex.org/I4405265692"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007356351","display_name":"Miyuki Harada","orcid":"https://orcid.org/0000-0003-1071-5600","observed_orcids":["https://orcid.org/0000-0003-1071-5600"]},"institutions":[{"id":"https://openalex.org/I74801974","display_name":"The University of Tokyo","ror":"https://ror.org/057zh3y96","country_code":"JP","type":"education","lineage":["https://openalex.org/I74801974"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Miyuki Harada","raw_affiliation_strings":["Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan","institution_ids":["https://openalex.org/I74801974"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5035399792","display_name":"Yutaka Osuga","orcid":"https://orcid.org/0000-0002-6660-1066","observed_orcids":["https://orcid.org/0000-0002-6660-1066"]},"institutions":[{"id":"https://openalex.org/I74801974","display_name":"The University of Tokyo","ror":"https://ror.org/057zh3y96","country_code":"JP","type":"education","lineage":["https://openalex.org/I74801974"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yutaka Osuga","raw_affiliation_strings":["Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan","institution_ids":["https://openalex.org/I74801974"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5048769237"],"corresponding_institution_ids":["https://openalex.org/I203951103"],"apc_list":{"value":3520,"currency":"USD","value_usd":3520},"apc_paid":{"value":3520,"currency":"USD","value_usd":3520},"fwci":5.7466,"has_fulltext":true,"cited_by_count":11,"citation_normalized_percentile":{"value":0.96563243,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":93,"max":99},"biblio":{"volume":"51","issue":"4","first_page":"e16292","last_page":"e16292"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11156","display_name":"Reproductive Health and Technologies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11156","display_name":"Reproductive Health and Technologies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10600","display_name":"Reproductive Health and Contraception","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/assisted-reproductive-technology","display_name":"assisted reproduction","score":0.9950000047683716},{"id":"https://openalex.org/keywords/insurance-coverage","display_name":"insurance coverage","score":0.843999981880188},{"id":"https://openalex.org/keywords/art-utilization","display_name":"ART utilization","score":0.7990000247955322},{"id":"https://openalex.org/keywords/out-of-pocket-costs","display_name":"out-of-pocket costs","score":0.7910000085830688},{"id":"https://openalex.org/keywords/urban-rural-differences","display_name":"urban-rural differences","score":0.9020000100135803},{"id":"https://openalex.org/keywords/japan","display_name":"Japan","score":0.3700000047683716}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8474420309066772},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.6614301204681396},{"id":"https://openalex.org/C158739034","wikidata":"https://www.wikidata.org/wiki/Q1907114","display_name":"Metropolitan area","level":2,"score":0.5382080078125},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.4917161762714386},{"id":"https://openalex.org/C2983635472","wikidata":"https://www.wikidata.org/wiki/Q334911","display_name":"Health insurance","level":3,"score":0.4709005653858185},{"id":"https://openalex.org/C500014431","wikidata":"https://www.wikidata.org/wiki/Q25862","display_name":"Assisted reproductive technology","level":4,"score":0.4428052008152008},{"id":"https://openalex.org/C2777688143","wikidata":"https://www.wikidata.org/wiki/Q179399","display_name":"Infertility","level":3,"score":0.4190214276313782},{"id":"https://openalex.org/C129047720","wikidata":"https://www.wikidata.org/wiki/Q175185","display_name":"Rural area","level":2,"score":0.41126304864883423},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3659082055091858},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.324174165725708},{"id":"https://openalex.org/C2779234561","wikidata":"https://www.wikidata.org/wiki/Q11995","display_name":"Pregnancy","level":2,"score":0.25837019085884094},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.2555043697357178},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.22924292087554932},{"id":"https://openalex.org/C54355233","wikidata":"https://www.wikidata.org/wiki/Q7162","display_name":"Genetics","level":1,"score":0.0},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006297","descriptor_name":"Health Services Accessibility","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D007564","descriptor_name":"Japan","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011795","descriptor_name":"Surveys and Questionnaires","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019458","descriptor_name":"Insurance Coverage","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D027724","descriptor_name":"Reproductive Techniques, Assisted","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D027724","descriptor_name":"Reproductive Techniques, Assisted","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1111/jog.16292","doi":"https://doi.org/10.1111/jog.16292","is_oa":true,"landing_page_url":"https://doi.org/10.1111/jog.16292","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jog.16292","source":{"id":"https://openalex.org/S4210240629","display_name":"Journal of obstetrics and gynaecology research","issn_l":"1341-8076","issn":["1341-8076","1447-0756"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Obstetrics and Gynaecology Research","raw_type":"journal-article"},{"id":"pmh:oai:europepmc.org:10809244","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11997234","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":null,"raw_type":"Text"},{"id":"pmid:40229928","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40229928","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The journal of obstetrics and gynaecology research","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11997234","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11997234/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Obstet Gynaecol Res","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1111/jog.16292","doi":"https://doi.org/10.1111/jog.16292","is_oa":true,"landing_page_url":"https://doi.org/10.1111/jog.16292","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jog.16292","source":{"id":"https://openalex.org/S4210240629","display_name":"Journal of obstetrics and gynaecology research","issn_l":"1341-8076","issn":["1341-8076","1447-0756"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Obstetrics and Gynaecology Research","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9629999995231628,"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities"},{"score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G1856495016","display_name":"Mechanism of aging and healthy problems: Conversion of extracellular vesicle-forming system","funder_award_id":"21K18298","funder_id":"https://openalex.org/F4320334764","funder_display_name":"Japan Society for the Promotion of Science"}],"funders":[{"id":"https://openalex.org/F4320334764","display_name":"Japan Society for the Promotion of Science","ror":"https://ror.org/00hhkn466"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4409469865.pdf","grobid_xml":"https://content.openalex.org/works/W4409469865.grobid-xml"},"referenced_works_count":16,"referenced_works":["https://openalex.org/W1878422748","https://openalex.org/W1992593914","https://openalex.org/W2007848905","https://openalex.org/W2024876959","https://openalex.org/W2063996923","https://openalex.org/W2169182249","https://openalex.org/W2193892683","https://openalex.org/W4221095619","https://openalex.org/W4308558737","https://openalex.org/W4386209735","https://openalex.org/W4390451345","https://openalex.org/W4400334704","https://openalex.org/W4401497407","https://openalex.org/W4403237603","https://openalex.org/W4405404316","https://openalex.org/W4407348599"],"related_works":["https://openalex.org/W4407348599","https://openalex.org/W4389160974","https://openalex.org/W7118542932","https://openalex.org/W7203836814","https://openalex.org/W2899031668","https://openalex.org/W7134138514","https://openalex.org/W4384664319","https://openalex.org/W3194649109","https://openalex.org/W4282976192","https://openalex.org/W4393989606"],"abstract_inverted_index":{"AIM:":[0],"Assisted":[1],"reproductive":[2],"technology":[3],"(ART)":[4],"is":[5],"a":[6,58,108,177],"well-established":[7],"infertility":[8],"treatment.":[9],"However,":[10,124,225],"financial":[11],"and":[12,43,187,222],"geographical":[13],"barriers":[14],"can":[15],"hinder":[16],"patient":[17,191,211],"access.":[18],"The":[19,79,96],"Japanese":[20],"government":[21],"implemented":[22],"insurance":[23,38,94],"coverage":[24,39,209],"in":[25,57,117,157,161,201,219,230,237],"April":[26],"2022":[27],"for":[28,217,251],"specific":[29],"ART":[30,41,53,82,214,253],"treatments.":[31],"This":[32],"study":[33],"assessed":[34],"the":[35,91,118,125,182,188,226,231,246],"effects":[36],"of":[37,72,81,93,98,111,127,141,184,190,228,248],"on":[40],"utilization":[42],"accessibility.":[44,254],"METHODS:":[45],"An":[46],"online":[47],"survey":[48],"was":[49,176,199],"administered":[50],"to":[51,65,120,213],"427":[52],"facilities":[54,74,136,145],"that":[55],"participated":[56],"pre-policy":[59],"assessment":[60],"from":[61],"December":[62],"1,":[63],"2023,":[64],"January":[66],"30,":[67],"2024.":[68],"RESULTS:":[69],"A":[70],"total":[71],"283":[73],"responded":[75],"(response":[76],"rate:":[77],"66.3%).":[78],"number":[80,97,126,140,227],"patients":[83,100,129,229],"increased":[84,104,139],"by":[85,105,133],"4.0%":[86],"(217":[87],"699-226":[88],"401)":[89],"following":[90],"implementation":[92],"coverage.":[95],"insured":[99],"aged":[101,130],"25-43":[102],"years":[103],"6.6%,":[106],"with":[107],"notable":[109],"increase":[110,148,192],"22.9%":[112],"(range:":[113],"44":[114],"144-54":[115],"253)":[116],"25-":[119],"34-year":[121],"age":[122],"group.":[123],"uninsured":[128,232],"\u226544":[131],"decreased":[132,234],"16.3%;":[134],"172":[135],"experienced":[137,146],"an":[138],"patients,":[142],"whereas":[143],"111":[144],"no":[147,196],"or":[149],"decline.":[150],"Patient":[151],"growth":[152],"rates":[153],"were":[154],"significantly":[155],"higher":[156],"rural":[158,202,238],"areas":[159,203,239],"than":[160],"metropolitan":[162],"regions":[163],"(mean":[164],"difference:":[165],"0.07;":[166],"95%":[167],"confidence":[168],"interval:":[169],"0.0-0.1;":[170],"p":[171],"=":[172,194,205],"0.03).":[173],"Although":[174],"there":[175],"significant":[178],"negative":[179],"association":[180,198],"between":[181],"proportion":[183],"out-of-pocket":[185],"treatment":[186],"rate":[189],"(p":[193,204],"0.02),":[195],"such":[197],"observed":[200],"0.68).":[206],"CONCLUSIONS:":[207],"Insurance":[208],"improved":[210],"access":[212],"services,":[215],"especially":[216],"those":[218],"their":[220],"20s":[221],"early":[223],"30s.":[224],"group":[233],"significantly.":[235],"Accessibility":[236],"also":[240],"notably":[241],"improved.":[242],"These":[243],"findings":[244],"highlight":[245],"importance":[247],"economic":[249],"support":[250],"enhancing":[252]},"counts_by_year":[{"year":2026,"cited_by_count":9},{"year":2025,"cited_by_count":2}],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2025-04-16T00:00:00"}
