Henderson Jillian T, Weisman Carol S, Grason Holly
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, USA.
Womens Health Issues. 2002 May-Jun;12(3):138-49. doi: 10.1016/s1049-3867(02)00134-2.
This study examines nonelderly women's concurrent use of two types of physicians (generalists and obstetrician-gynecologists) for regular health care and associations with receipt of preventive care, including a range of recommended screening, counseling, and heart disease prevention services. Data are from the 1999 Women's Health Care Experiences Survey conducted in Baltimore, Maryland, using random digit dialing (N = 509 women ages 18 to 64). Key findings are: 58% of women report using two physicians (a generalist and an ob/gyn) for regular care; seeing both a generalist and an ob/gyn, compared with seeing a generalist alone, is consistently associated with receiving more clinical preventive services, including screening, counseling, and preventive services related to heart disease. Because seeing an ob/gyn in addition to a generalist physician is associated with receiving recommended preventive services (even for heart disease), the findings suggest that non-elderly women who rely on a generalist alone may receive substandard preventive care. The implications for women's access to ob/gyns and for appropriate design of women's primary care are discussed.
本研究调查了非老年女性同时使用两种类型医生（全科医生和妇产科医生）进行常规医疗保健的情况，以及与接受预防性保健的关联，包括一系列推荐的筛查、咨询和心脏病预防服务。数据来自1999年在马里兰州巴尔的摩进行的女性医疗保健经历调查，采用随机数字拨号法（N = 509名年龄在18至64岁之间的女性）。主要发现如下：58%的女性报告称使用两位医生（一位全科医生和一位妇产科医生）进行常规保健；与仅看全科医生相比，同时看全科医生和妇产科医生与接受更多临床预防性服务始终相关，包括筛查、咨询以及与心脏病相关的预防性服务。由于除了全科医生外还看妇产科医生与接受推荐的预防性服务（甚至是与心脏病相关的服务）相关，研究结果表明，仅依赖全科医生的非老年女性可能接受的预防性保健不达标准。文中还讨论了这些发现对女性获得妇产科医疗服务的影响以及对女性初级保健合理设计的影响。
