Godfrey Emily M, Thayer Erin K, Fiastro Anna E, Aiken Abigail R A, Gomperts Rebecca
Department of Family Medicine, University of Washington, Seattle, WA United States; Department of Obstetrics and Gynecology, University of Washington, Seattle, WA United States.
Department of Family Medicine, University of Washington, Seattle, WA United States.
Contraception. 2021 Jul;104(1):54-60. doi: 10.1016/j.contraception.2021.04.026. Epub 2021 Apr 30.
To examine provision of direct-to-patient medication abortion during COVID-19 by United States family physicians through a clinician-supported, asynchronous online service, Aid Access.
We analyzed data from United States residents in New Jersey, New York, and Washington who requested medication abortion from 3 family physicians using the online service from Aid Access between April and November 2020. This study seeks to examine individual characteristics, motivations, and geographic locations of patients receiving abortion care through the Aid Access platform.
Over 7 months, three family physicians using the Aid Access platform provided medication abortion care to 534 residents of New Jersey, New York, and Washington. There were no demographic differences between patients seeking care in these states. A high percentage (85%) were less than 7 weeks gestation at the time of their request for care. The reasons patients chose Aid Access for abortion services were similar regardless of state residence. The majority (71%) of Aid Access users lived in urban areas. Each family physician provided care to most counties in their respective states. Among those who received services in the three states, almost one-quarter (24%) lived in high Social Vulnerability Index (SVI) counties, with roughly one-third living in medium-high SVI counties (33%), followed by another quarter (26%) living in medium-low SVI counties.
Family physicians successfully provided medication abortion in three states using asynchronous online consultations and medications mailed directly to patients.
Primary care patients are requesting direct-to-patient first trimester abortion services online. By providing abortion care online, a single provider can serve the entire state, thus greatly increasing geographic access to medication abortion.
通过临床医生支持的异步在线服务“援助通道”（Aid Access），研究美国家庭医生在新冠疫情期间为患者直接提供药物流产服务的情况。
我们分析了2020年4月至11月期间，新泽西州、纽约州和华盛顿州的美国居民通过“援助通道”在线服务向3位家庭医生请求药物流产的数据。本研究旨在调查通过“援助通道”平台接受流产护理的患者的个人特征、动机和地理位置。
在7个多月的时间里，3位使用“援助通道”平台的家庭医生为新泽西州、纽约州和华盛顿州的534名居民提供了药物流产护理。这些州寻求护理的患者在人口统计学上没有差异。在请求护理时，高比例（85%）的患者妊娠少于7周。无论居住在哪个州，患者选择“援助通道”进行流产服务的原因相似。大多数（71%）“援助通道”用户居住在城市地区。每位家庭医生为各自州的大多数县提供护理。在这三个州接受服务的人群中，近四分之一（24%）居住在社会脆弱性指数（SVI）高的县，约三分之一居住在SVI中高的县（33%），另有四分之一（26%）居住在SVI中低的县。
家庭医生通过异步在线咨询和直接邮寄药物，成功地在三个州提供了药物流产服务。
初级保健患者正在在线请求直接面向患者的孕早期流产服务。通过在线提供流产护理，单一提供者可以服务整个州，从而大大增加了药物流产的地理可及性。
