Where do reproductive-age women receive preve

A study from the University of Massachusetts Amherst found that although preventive care is usually associated with primary care providers, the majority of clinic visits for preventive services in women of childbearing age were made by obstetricians and gynecologists (OB-GYN). ) is shown to be done.

More than 40% of preventive care visits were OB-GYNs, even among women of reproductive age with chronic health conditions. is also made clear. For example, depression screening was done in only 6% of primary care visits and her just under 4% of OB-GYN visits.

Health services researcher Laura Attanasio, assistant professor of health policy and management at the University of Massachusetts School of Public Health and Health Sciences, said in a study published in Health Services Research that examined services received by women, particularly those with chronic conditions. is the lead author of in preventative visits since the Affordable Care Act was passed in her 2010.

“Preventive care is key to optimizing health,” says Attanasio. “Various policy actions have been taken over the years to try to increase people’s access to preventive health care, including provisions of the Affordable Care Act. The service was required to be covered free of charge to the patient for that visit or that service.”

Typically, these initiatives “are aimed at primary care, but do not necessarily account for the fact that in practice women of reproductive age primarily see obstetrics and gynecology for preventive care,” he said. she adds.

Attanasio and team analyzed data from the National Ambulatory Care Survey of Office-Based Physicians from 2011 to 2018. Specifically, they examined preventive care visits for women of reproductive age in an obstetrics and gynecology office or general practitioner setting (either family physician, internist, or pediatrician).

This data provides a national sample based on visits rather than the care received by individuals over time.

“When looking at the services provided by type of doctor, it is not surprising that obstetrics and gynecology departments place more emphasis on reproductive-related services, such as Pap testing, vaginal examinations, and contraceptive provision,” Attanasio said. says Mr. “Non-reproductive services were more common than general practitioner visits: lipid tests, diabetic glucose tests, complete blood counts, etc.”

This pattern was similar across the fertile female patient population and when the sample was restricted to women of reproductive age with chronic conditions such as depression, diabetes, asthma, hypertension and high cholesterol.

According to Attanasio, about 30% of GP visits included lipid testing for cholesterol levels, compared with a “surprisingly low” 2.8% of OB-GYN visits.

“Conversely, some reproductive-related services may be underserved at primary care visits,” she says. You can see that there are quite a lot of differences between disciplines.”

There’s a reason for that, Attanasio points out. Guidelines for preventive care are updated frequently, require changes in clinical practice, and guidelines may vary among professional organizations. The findings of this study can inform additional research to determine where women of reproductive age, especially those with chronic conditions, are best served with preventive health services.

The paper concludes: Given the slow and uneven incorporation of new guidelines into clinical practice, the trend in service delivery is likely to persist. “