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有慢性疾病的育龄期女性与妇产科医生和全科医生的预防保健就诊。

Preventive care visits with OB/GYNs and generalist physicians among reproductive-age women with chronic conditions.

机构信息

Department of Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, USA.

出版信息

Health Serv Res. 2023 Feb;58(1):207-215. doi: 10.1111/1475-6773.14100. Epub 2022 Nov 24.

Abstract

OBJECTIVE

To examine services delivered during preventive care visits among reproductive-age women with and without chronic conditions by physician specialty.

DATA SOURCES

National Ambulatory Medical Care Surveys (2011-2018).

STUDY DESIGN

We examined provision of specific services during preventive care visits by physician specialty among reproductive-age female patients, overall and among women with five common chronic conditions (diabetes, hypertension, depression, hyperlipidemia, and asthma).

DATA COLLECTION/EXTRACTION METHODS: The sample included preventive visits to OB/GYNs or generalist physicians where the patient was female, age 18-44, and not pregnant.

PRINCIPAL FINDINGS

In OB/GYN preventive visits, reproductive health services were more likely to be provided, while non-reproductive health services were less likely to be provided, both among reproductive-age female patients overall and among those with chronic conditions. For example, pap tests were provided in 44.5% of OB/GYN preventive visits (95% CI: 40.6-48.4) and in 21.4% of generalist preventive visits (95% CI: 17.2-26.6). Lipid testing was provided in 2.8% of OB/GYN preventive visits (95% CI: 1.7-3.9) and in 30.3% of generalist preventive visits (95% CI: 26.1-34.6).

CONCLUSIONS

Understanding the full range of care received in preventive visits across settings could guide recommendations to optimize where reproductive-age women with chronic conditions seek care.

摘要

目的

按医师专业检查有和无慢性病的育龄期女性在预防保健就诊时提供的服务。

数据来源

国家门诊医疗调查(2011-2018 年)。

研究设计

我们按医师专业检查了育龄期女性患者的预防保健就诊中具体服务的提供情况,包括总体情况以及五种常见慢性病(糖尿病、高血压、抑郁症、高脂血症和哮喘)患者的情况。

数据收集/提取方法:样本包括妇产科医生或全科医生的预防就诊,患者为女性,年龄 18-44 岁,未怀孕。

主要发现

在妇产科预防就诊中,更有可能提供生殖健康服务,而非生殖健康服务则不太可能提供,这两种情况在所有育龄期女性患者中以及慢性病患者中都是如此。例如,巴氏涂片检查在妇产科预防就诊中提供的比例为 44.5%(95%CI:40.6-48.4),在全科医生预防就诊中提供的比例为 21.4%(95%CI:17.2-26.6)。血脂检测在妇产科预防就诊中提供的比例为 2.8%(95%CI:1.7-3.9),在全科医生预防就诊中提供的比例为 30.3%(95%CI:26.1-34.6)。

结论

了解在不同环境中预防就诊中获得的全面护理范围,可以为有慢性病的育龄期女性选择就诊地点提供指导建议,以优化其护理。

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