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Access to single-visit IUD insertion at obstetrician-gynecology practices in Ohio: An audit study.

Abstract：

OBJECTIVE:Single-visit intrauterine device (IUD) insertion protocols are recommended. We assessed the availability of single-visit IUD insertions, and whether access to these services varies by age, race or parity. STUDY DESIGN:Using audit study methodology, we called a random sample of 396 obstetrician-gynecology practices in Ohio while posing as a potential client seeking an IUD insertion appointment. Callers used eight standardized scripts and noted justifications for protocols offered by clinic staff. Practices were randomized to follow a balanced 3×2 factorial design, whereby practices were assigned to one of two conditions: (1) age (18 vs. 30 years of age); (2) race (white vs. black); and (3) parity. Multivariable logistic regression was used to control for clinics rural vs. urban location while considering the effects of these variables on service provision. RESULTS:Almost all (95%) of the practices called offered IUD placement, of which 92% required multiple appointments for IUD insertion. Although access to single-visit IUD services did not vary by age or race, we found that parity was associated with clinics' willingness to schedule a single-visit insertion visit (OR = 3.84, 95% CI = 1.23, 12.04). The most frequent justification provided by clinic staff for their multiple-appointment protocol was the need to verify insurance coverage or order the device directly through the patient's insurance company. CONCLUSION:Ohio patients seeking IUD placement must typically make more than one clinic visit. IMPLICATIONS:Efforts are needed to reassure Ohio clinics that IUDs are routinely covered by insurers and to increase access to same-day IUD placement for women in Ohio, as the requirement to attend multiple clinics appointments to obtain a desired contraceptive may pose an insurmountable barrier to care for those with the fewest resources.

journal_name

Contraception

journal_title

Contraception

authors

Serpico JJ,Ricks JM,Smooth WG,Romanos C,Brook DL,Gallo MF

doi

10.1016/j.contraception.2020.05.007

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

190-194

issue

eissn

0010-7824

issn

1879-0518

pii

S0010-7824(20)30155-4

journal_volume

102

pub_type

杂志文章

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Access to single-visit IUD insertion at obstetrician-gynecology practices in Ohio: An audit study.