Raffoul Melanie C, Petterson Stephen M, Rayburn William F, Wingrove Peter, Bazemore Andrew W
1 Robert Graham Center, Center for Policy Studies , American Academy of Family Physicians, Washington, District of Columbia.
2 Department of Obstetrics and Gynecology, University of New Mexico School of Medicine , Albuquerque, New Mexico .
J Womens Health (Larchmt). 2016 Dec;25(12):1231-1236. doi: 10.1089/jwh.2015.5599. Epub 2016 Sep 1.
The increase in access to healthcare through the Affordable Care Act highlights the need to track where women seek their office-based care. The objectives of this study were to examine the types of physicians sought by women beyond their customary reproductive years and before being elderly.
This retrospective cohort study involved an analysis of national data from the Medical Expenditure Panel Survey (MEPS) between 2002 and 2012. Women between 45 and 64 years old (n = 44,830) were interviewed, and reviews of corresponding office visits (n = 330,114) were undertaken.
In 2002, women aged 45-64 years (62%) went to a family or internal medicine physician only and this reached 72% in 2012. The percentage of women who went to an obstetrician-gynecologist (ob-gyn) only decreased from 20% in 2002 to 12% in 2012. Most went to a family physician or general internist for a general checkup or for diagnosis or treatment. By contrast, visits to ob-gyn physicians were predominantly for general checkups. Those who went to an ob-gyn office were more likely to have a higher family income, live in the Northeast, and describe their overall health as being excellent.
Women aged 45-64 years were substantially more likely to obtain care exclusively at offices of family physicians or general internists than of ob-gyn physicians. Overlap in care provided at more than one physician's office requires continued surveillance in minimizing redundant cost and optimizing resource utilization.
通过《平价医疗法案》增加医疗保健服务的可及性,凸显了追踪女性寻求门诊医疗服务地点的必要性。本研究的目的是调查处于非传统生育年龄且未步入老年的女性所寻求的医生类型。
这项回顾性队列研究涉及对2002年至2012年医疗支出面板调查(MEPS)的全国数据进行分析。对45至64岁的女性(n = 44,830)进行了访谈,并对相应的门诊就诊情况(n = 330,114)进行了审查。
2002年,45至64岁的女性中(62%)仅就诊于家庭医生或内科医生,到2012年这一比例达到72%。仅就诊于妇产科医生的女性比例从2002年的20%降至2012年的12%。大多数女性因进行全面检查或诊断、治疗而去看家庭医生或普通内科医生。相比之下,看妇产科医生主要是为了进行全面检查。去妇产科诊所就诊的女性更有可能家庭收入较高、居住在东北部,且将自己的整体健康状况描述为极佳。
45至64岁的女性在家庭医生或普通内科医生办公室而非妇产科医生办公室接受医疗服务的可能性要大得多。在多个医生办公室提供的医疗服务存在重叠,需要持续监测以尽量减少冗余成本并优化资源利用。