Dr. Jacqueline Ellison’s research focuses on how policies and clinical interventions impact sexual and reproductive health care access and outcomes.
The role of insurance on reproductive and perinatal health inequities
People with capacity for pregnancy are disproportionately affected by health financing policies because they are higher users of health care. They shoulder the primary responsibility of preventing and terminating unwanted pregnancies in an increasingly hostile political environment, as well as ensuring healthy pregnancies and coordinating care for their families. The focus of this research is to understand how insurance coverage, reimbursement, and other financing policies uniquely impact this population. Ongoing research in this area includes: 1) evaluating the effect of the COVID19 pandemic on Medicaid/commercial coverage disparities in postpartum depression diagnosis and treatment; and 2) understanding contraceptive use by Medicare enrollees living with a disability.
Identifying the prevalence and outcomes of screening pelvic exams
Despite widespread use, there is no empirical evidence supporting the clinical value of pelvic exam for screening purposes. This effectiveness uncertainty has been reflected more recently in changing clinical guidelines, some of which are ambiguous and conflicting. Establishing evidence on the potential benefits and indirect harms of screening pelvic exam is critical because people who experience pain or discomfort during pelvic exam may avoid other preventive care, and false-positive pelvic exam results could initiate a costly cascade of unnecessary care. This research is focused on leveraging insurance claims and medical record data to: 1) evaluate the effects of clinical guideline multiplicity on the prevalence of screening pelvic exams in primary care settings; and 2) identify and characterize the cascades of care initiated by abnormal screening pelvic exams.