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A population-based study of US women's preferred versus usual sources of reproductive health care.

Abstract：

OBJECTIVE:We characterized US women's preferred and usual sources of reproductive health care. STUDY DESIGN:Data were drawn from the Women's Health Care Experiences and Preferences Study, an Internet survey of 1078 women aged 18-55 years randomly sampled from a national probability panel. We described and compared women's preferred and usual sources of care (women's health specialists including obstetricians-gynecologists and family-planning clinics, primary care, other) for Papanicolaou/pelvic examination, contraception, and sexually transmitted infection (STI) services using χ(2), logistic regression, and kappa statistics. RESULTS:Among women reporting health service utilization (n = 984, 92% overall; 77% Papanicolaou/pelvic; 33% contraception; 8% STI), women's health specialists were the most used sources of care for Papanicolaou/pelvic (68%), contraception (74%), and STI (75%) services. Women's health specialists were also the most preferred care sources for Papanicolaou/pelvic (68%), contraception (49%), and STI (35%) services, whereas the remainder of women preferred primary care/other sources or not to get care. Differences in preferred and usual care sources were noted across sociodemographic groups, including insurance status and income level (P < .05). Preference for women's health specialists was the strongest predictor of women's health specialist utilization for Papanicolaou/pelvic (adjusted odds ratio, 48.8; 95% confidence interval, 25.9-91.8; P < .001) and contraceptive (adjusted odds ratio, 194.5; 95% confidence interval, 42.3-894.6; P < .001) services. Agreement between preferred and usual-care sources was high for Papanicolaou/pelvic (85%, kappa, 0.63) and contraception (86%; kappa, 0.64) services; disagreement (range, 15-22%) was associated with insurance, employment, income, race, and religion (P < .05). CONCLUSION:Women's preferences for and use of women's health specialists for reproductive health care has implications for efforts to define the role of obstetricians-gynecologists and family planning clinics in current health systems.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Hall KS,Patton EW,Crissman HP,Zochowski MK,Dalton VK

doi

10.1016/j.ajog.2015.04.025

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

352.e1-14

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(15)00389-0

journal_volume

213

pub_type

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A population-based study of US women's preferred versus usual sources of reproductive health care.