University of Washington, Department of Family Medicine, Seattle, WA, United States.
University of Washington, Department of Family Medicine, Seattle, WA, United States.
Contraception. 2022 Oct;114:26-31. doi: 10.1016/j.contraception.2022.04.009. Epub 2022 Apr 27.
Primary care providers are a major source of sexual and reproductive health care in the United States, particularly in rural areas, and not all providers offer the same services. This study aimed to understand patient preferences and expectations around reproductive health services including abortion care in a primary care setting and if those expectations differed by urban or rural setting.
An anonymous survey was distributed to all patients 18 years or older in 4 primary care clinics in Idaho, Washington, and Wyoming over a 2-week period. The survey asked patients about which reproductive health services should be available in primary care.
The overall response rate was 69% (745/1086). For all queried reproductive health services except for aspiration abortion, the majority of respondents reported that primary care clinics should have that service available. Forty-two percent of respondents reported that aspiration abortion should be available in primary care. Overall, most respondents reported that medication abortion (58%) and miscarriage management (65%) should be available in primary care. More respondents in urban clinics thought IUD services (84% vs 71%), medication abortion (74% vs 37%), and aspiration abortion (52% vs 28%) should be accessible in primary care compared to those in rural-serving clinics.
This study of 4 primary care clinics in Idaho, Washington, and Wyoming, spanning urban and rural settings, highlights that most patients desire contraception services and miscarriage management to be available in primary care.
Increasing training may help meet patient desires for access to reproductive services in primary care, however, further exploration of barriers to this care is warranted. High rates of respondents desiring miscarriage management access highlights the need to train more primary care clinicians to provide full spectrum miscarriage management options.
初级保健提供者是美国性健康和生殖健康护理的主要来源，尤其是在农村地区，并非所有提供者都提供相同的服务。本研究旨在了解患者对初级保健环境中生殖健康服务（包括堕胎护理）的偏好和期望，以及这些期望是否因城市或农村环境而有所不同。
在爱达荷州、华盛顿州和怀俄明州的 4 个初级保健诊所中，在 2 周的时间内向所有 18 岁及以上的患者分发匿名调查。该调查询问患者在初级保健中应提供哪些生殖健康服务。
总体回复率为 69%（745/1086）。对于除抽吸性堕胎以外的所有被询问的生殖健康服务，大多数受访者表示初级保健诊所应提供该服务。42%的受访者表示抽吸性堕胎应在初级保健中提供。总体而言，大多数受访者表示药物性堕胎（58%）和流产管理（65%）应在初级保健中提供。与农村诊所相比，城市诊所的更多受访者认为宫内节育器服务（84%比 71%）、药物性堕胎（74%比 37%）和抽吸性堕胎（52%比 28%）应在初级保健中提供。
这项对爱达荷州、华盛顿州和怀俄明州的 4 个初级保健诊所的研究，涵盖了城市和农村环境，突出表明大多数患者希望在初级保健中提供避孕服务和流产管理。
增加培训可能有助于满足患者对初级保健中获得生殖服务的需求，但需要进一步探讨获得这种护理的障碍。希望获得流产管理的受访者比例很高，这突显了需要培训更多的初级保健临床医生，以提供全面的流产管理选择。
