A significant cost differential obviously exists between inpatient and outpatient abortion services. The feasibility of providing outpatient vacuum aspiration procedures has been adequately demonstrated during the past few years, and as the fraction of women seeking early abortion increases the use of outpatient facilities should also increase. The effects of such a shift were also investigated.As the fraction of outpatient abortions was increased from a low of 10 per cent to a high of 90 per cent, the costs of providing services decreased by about one-third. Hospital patient-day requirements dropped dramatically. Such a shift requires, however, that women with preexisting conditions that may significantly increase their risk of mortality or morbidity be carefully screened and directed to the facility best able to treat them.The importance of the time point in pregnancy that the abortion is performed is evident. Early abortions have a multitude of health and economic benefits whereas late abortions present both an increased burden to the health care system and an increased threat to the woman's health.The national requirements for abortion services, at the level of services experienced in New York, or even somewhat higher, are not excessive. The space each facility, and the time each gynecologist, would have to allocate to these services is also not excessive, especially as an increasing fraction of abortions are performed during early pregnancy.Alternatives to abortion should also be widely available. The importance of contraceptive services, infertility treatment, and other aspects of comprehensive medical care for human reproduction should also be emphasized.
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