{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:50:42Z","timestamp":1787626242852,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1105603"],"award-info":[{"award-number":["1105603"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2024,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess changes in the monthly numbers of hospital\u2010based abortions and outpatient early medical abortions in Victoria during January 2012 \u2013 March 2022, with a particular interest in the impact of the coronavirus disease 2019 (COVID\u201019) pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Population\u2010based retrospective cohort study; time series analysis of Victorian Admitted Episodes Dataset (VAED) and Pharmaceutical Benefits Scheme (PBS) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting, participants<\/jats:title><jats:p>All admitted care episodes in Victoria during 1 January 2012 \u2013 31 March 2022 with medical abortion as the principal diagnosis; all PBS claims for mifepristone\u2013misoprostol (MS\u20102 Step) during 1 January 2015 (date of listing) \u2013 31 March 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Changes in monthly numbers (with 95% confidence intervals [CIs]) of admissions for hospital\u2010based and outpatient early medical abortions during the pre\u2010pandemic period (January 2012 \u2013 March 2020), the first full month of the COVID\u201019 pandemic (April 2020), and the pandemic period (May 2020 \u2013 March 2022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The monthly number of hospital\u2010based abortions declined in Victoria during the pre\u2010pandemic period (slope, \u20132.92 [95% CI, \u20133.45 to \u20132.38] per month); the rate of decline was greater during the pandemic period (slope, \u20135.74 [95% CI, \u201310.5 to \u20130.96] per month). The monthly number of outpatient early medical abortions increased during the pre\u2010pandemic period (slope, 5.94 [95% CI, 5.34\u20136.34] per month); it declined during the first month of the pandemic (slope, \u201326.4 [95% CI, \u201370.1 to \u201317.3] per month), but did not significantly change thereafter. The total monthly number of abortions during the pandemic period did not deviate markedly from the pre\u2010pandemic median value. The pre\u2010pandemic declines in monthly numbers of abortions in major city hospitals, in private hospitals, or at earlier than 14 weeks\u2019 gestation intensified during the pandemic period. During January 2015 \u2013 March 2020, 14\u2009634 of 103\u2009496 abortions were outpatient medical abortions (14%); during the pandemic period, 11\u2009154 of 33\u2009056 abortions were outpatient medical abortions (33%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of outpatient early medical abortion has steadily increased in Victoria since the PBS listing of mifepristone\u2013misoprostol, which helped ensure access to abortion during the COVID\u201019 pandemic. Outpatient medical abortions may eventually outnumber surgical early abortions in Victoria, but they are not always appropriate: hospitals will continue to be essential for comprehensive abortion care.<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52203","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T12:40:35Z","timestamp":1706877635000},"page":"145-153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Changes in the numbers of hospital\u2010based abortions and outpatient early medical abortions in Victoria, 2012\u201322: a retrospective cohort study"],"prefix":"10.5694","volume":"220","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-7335","authenticated-orcid":false,"given":"Melvin B","family":"Marzan","sequence":"first","affiliation":[{"name":"Melbourne Medical School the University of Melbourne  Melbourne VIC"},{"name":"Murdoch Children's Research Institute  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Johnson","sequence":"additional","affiliation":[{"name":"Northern Centre for Health Education Research Northern Health  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Moore","sequence":"additional","affiliation":[{"name":"Melbourne Medical School the University of Melbourne  Melbourne VIC"},{"name":"Royal Women's Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Jiang","sequence":"additional","affiliation":[{"name":"La Trobe University  Melbourne VIC"},{"name":"Centre for Health Equity the University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-3562","authenticated-orcid":false,"given":"Lisa","family":"Hui","sequence":"additional","affiliation":[{"name":"Melbourne Medical School the University of Melbourne  Melbourne VIC"},{"name":"Murdoch Children's Research Institute  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"e_1_2_9_1_1","unstructured":"Community Affairs References Committee.Ending the postcode lottery: addressing barriers to sexual maternity and reproductive healthcare in Australia. 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