摘要：CONTEXT: During its first year of operation (1997¨C1998), California¡¯s family planning program, Family PACT, helped
more than 750,000 clients to avert an estimated 108,000 pregnancies. Given subsequent increases in the numbers of
clients served and contraceptive methods offered by the program, updated estimates of its impact on fertility are
needed.
METHODS: Claims data on contraceptives dispensed were used to estimate the number of pregnancies experienced by
women in the program in 2002. Medical record data on methods used prior to enrollment were used to predict client
fertility in the absence of the program. Further analyses examined the sensitivity of these estimates to alternative assumptions
about contraceptive failure rates, contraceptive continuation and contraceptive use in the absence of program
services.
RESULTS: Almost 6.4 million woman-months of contraception, provided primarily by oral contraceptives (57%), barrier
methods (19%) and the injectable (18%), were dispensed through Family PACT during 2002. As a result, an estimated
205,000 pregnancies¡ªwhich would have resulted in 79,000 abortions and 94,000 births, including 21,400 births to
adolescents¡ªwere averted. Changing the base assumptions regarding contraceptive failure rates or method use had
relatively small effects on the estimates, whereas assuming that clients would use no contraceptives in the absence of
Family PACT nearly tripled the estimate of pregnancies averted.
CONCLUSION: Because all contraceptive methods substantially reduce the risk of pregnancy, Family PACT¡¯s impact on
preventing pregnancy lies primarily in providing contraceptives to women who would otherwise not use any method.
