Chase Brexton Health Care, Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231173555. doi: 10.1177/21501319231173555.
To determine associations between primary provider specialty and the contraceptive care that patients receive in a Federally Qualified Health Center setting in Maryland.
A study of reproductive-age patients and their providers was performed from January 2018 to December 2021. A pooled crosssectional survey of electronic medical record data for 44 127 encounters of 22 828 patients was performed to calculate the odds of contraceptive care being addressed by patients who had General Practitioner, OB/GYN, pediatrician, or infectious disease (ID) specialists as their primary providers.
In 19 041 encounters (43%), contraception was addressed through either counseling alone, documentation of a contraceptive prescription, or long-acting reversible contraceptive (LARC) placement procedure. After adjusting for insurance status and race/ethnicity, the odds ratio (OR) of contraceptive care delivery was statistically significantly higher for OB/GYN providers compared to General Practitioners-OR 2.42 (CI 2.29-2.53) and statistically significantly lower for ID providers-OR 0.69 (CI 0.61-0.79). There was a non-statistically significant difference for Pediatricians-OR 0.88 (CI 0.77-1.01).
The provision of contraceptive care, a critical aspect of comprehensive primary care delivered in an FQHC setting, varies by provider specialty, and may be negatively influenced by Ryan White funding related structures. There is a need to intentionally design robust referral and tracking systems to ensure contraceptive care is equitably accessible to all, regardless of assigned primary care provider specialty or HIV status.
在马里兰州的联邦合格健康中心（Federally Qualified Health Center）环境下，确定初级保健提供者的专业与患者接受避孕护理之间的关联。
对育龄患者及其提供者进行了一项研究，研究时间为 2018 年 1 月至 2021 年 12 月。对 44127 次就诊中 22828 名患者的电子病历数据进行了汇总横断面调查，以计算由全科医生、妇产科医生、儿科医生或传染病（ID）专家作为主要提供者的患者接受避孕护理的可能性。
在 19041 次就诊中（43%），通过咨询、记录避孕处方或长效可逆避孕（LARC）放置程序来解决避孕问题。在调整保险状况和种族/族裔后，与全科医生相比，妇产科医生提供避孕护理的可能性更高，比值比（OR）为 2.42（95%置信区间[CI]为 2.29-2.53），传染病医生的可能性更低，OR 为 0.69（95%CI 为 0.61-0.79）。儿科医生的差异无统计学意义，OR 为 0.88（95%CI 为 0.77-1.01）。
在 FQHC 环境下提供的避孕护理是综合性初级保健的重要组成部分，其提供情况因提供者的专业而异，可能会受到与 Ryan White 基金相关的结构的负面影响。需要有针对性地设计强大的转介和跟踪系统，以确保无论指定的初级保健提供者的专业或 HIV 状况如何，所有患者都能公平地获得避孕护理。
