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美国女性生殖健康护理的预期来源。

U.S. Women's Intended Sources for Reproductive Health Care.

作者信息

Crissman Halley P, Hall Kelli Stidham, Patton Elizabeth W, Zochowski Melissa K, Davis Matthew M, Dalton Vanessa K

机构信息

1 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.

2 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

出版信息

J Womens Health (Larchmt). 2016 Jan;25(1):91-8. doi: 10.1089/jwh.2014.5116. Epub 2015 Oct 26.

Abstract

INTRODUCTION

The current sociopolitical climate and context of the Affordable Care Act have led some to question the future role of family planning clinics in reproductive health care. We explored where women plan to get their future contraception, pelvic exam/pap smears, and sexually transmitted infection testing, with a focus on the role of family planning clinics.

METHODS

Data were drawn from a study of United States adults conducted in January 2013 from a national online panel. We focused on English-literate women aged 18-45 years who answered items on intended sources of care (private office/health maintenance organization [HMO], family planning clinic, other, would not get care) for reproductive health services. We used Rao-Scott F tests to compare intended sources across sociodemographic groups, and logistic regression to model odds of intending to use family planning clinics. Probability weights were used to adjust for the complex sampling design.

RESULTS

The response rate was 61% (n = 2,182). Of the 723 respondents who met the inclusion criteria, approximately half intended to use private offices/HMOs. Among some subgroups, including less educated (less than high school), lower annual incomes (<$25,000) and uninsured women, the proportion intending to use family planning clinics was higher than the proportion intending to use private office/HMO in unadjusted analyses. Across all service types, unmarried and uninsured status were associated with intention to use family planning clinics in multivariable models.

CONCLUSIONS

While many women intend to use private offices/HMOs for their reproductive health care, family planning clinics continue to play an important role, particularly for socially disadvantaged women.

摘要

引言

当前的社会政治气候以及《平价医疗法案》的背景使得一些人对计划生育诊所在生殖健康护理中的未来作用产生质疑。我们探究了女性未来计划获取避孕措施、盆腔检查/巴氏涂片检查以及性传播感染检测的地点,重点关注计划生育诊所的作用。

方法

数据来源于2013年1月对美国成年人进行的一项研究,该研究通过全国在线小组开展。我们聚焦于年龄在18 - 45岁、英语读写能力良好且回答了关于生殖健康服务预期护理来源(私人诊所/健康维护组织[HMO]、计划生育诊所、其他、不会接受护理)相关问题的女性。我们使用Rao - Scott F检验来比较不同社会人口学群体的预期护理来源,并使用逻辑回归来建立打算使用计划生育诊所的几率模型。概率权重用于调整复杂的抽样设计。

结果

回复率为61%(n = 2182)。在符合纳入标准的723名受访者中,约一半打算使用私人诊所/HMO。在一些亚组中,包括受教育程度较低(高中以下)、年收入较低(<$25000)以及未参保的女性,在未经调整的分析中,打算使用计划生育诊所的比例高于打算使用私人诊所/HMO的比例。在所有服务类型中,未婚和未参保状态在多变量模型中与打算使用计划生育诊所相关。

结论

虽然许多女性打算在生殖健康护理中使用私人诊所/HMO,但计划生育诊所继续发挥着重要作用,尤其是对社会弱势群体而言。

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