AUSTIN — Thousands of women have dropped out of a health care program since the state altered it seven months ago in a fight over Planned Parenthood, state statistics show. Since the state began operating its own Texas Women's Health Program, claims have dropped 23 percent, or about 4,000 visits monthly. The state broke from a Medicaid-funded program because federal rules allowed Planned Parenthood to deliver health services. Some Texas leaders insisted no organization that was affiliated with abortion providers should be allowed in the program. The effort was designed to cut off funding from Planned Parenthood, which was the largest provider of women's health services, but which also operated separate, privately funded abortion clinics. The program provides services such as cancer screenings.