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私人医生与向青少年提供避孕药具

Private physicians and the provision of contraceptives to adolescents.

作者信息

Orr M T

出版信息

Fam Plann Perspect. 1984 Mar-Apr;16(2):83-6.

PMID:6723944
Abstract

Data from a national sample of private physicians show that 86 percent of obstetrician-gynecologists, general practitioners and pediatricians are willing to prescribe contraceptive methods to adolescent women. However, only 59 percent are willing to serve unmarried minors without parental consent. The obstetrician-gynecologists are more likely to provide contraceptives than the other two specialists, and are likely to have fewer policy restrictions. Although pediatricians are the least willing to prescribe contraceptives (only 32 percent say they would do so for a 15-year-old patient), they are the most likely to refer such patients to other sources of care (61 percent of those who will not provide primary contraceptive care do so). The parental consent requirements that physicians set for contraceptive services are somewhat related to state policies. Seventy-five percent of physicians who provide contraceptive care for adolescents and who practice in states that clearly authorize minors to give their own consent for family planning services will serve unmarried minors on their own consent, compared with 62 percent in states without explicit minor consent laws. Physicians practicing in the Southwest are the most likely to provide contraceptive services to unmarried patients younger than 18, while those in the North are least likely to do so (88 and 67 percent, respectively). Ninety percent of private physicians who prescribe contraceptives for adolescent women will prescribe the pill, but smaller proportions will make the diaphragm or IUD available (61 and 23 percent, respectively). Among the physicians surveyed, the average fee that an adolescent would have to pay for an initial contraceptive visit, including laboratory tests, is $37. Of those who accept teenage contraceptive patients, only 53 percent will accept Medicaid reimbursement and only one percent indicate that they will instead provide free services to adolescents who cannot afford to pay the fee.

摘要

一项针对全国私人执业医生的抽样调查数据显示,86%的妇产科医生、全科医生和儿科医生愿意为青春期女性开避孕药。然而,只有59%的医生愿意在未经父母同意的情况下为未婚未成年人提供服务。妇产科医生比其他两类专科医生更有可能提供避孕药具,而且可能受到的政策限制更少。尽管儿科医生最不愿意开避孕药(只有32%的儿科医生表示会为15岁的患者开避孕药),但他们最有可能将这类患者转介到其他医疗机构(在那些不提供主要避孕服务的儿科医生中,61%会这么做)。医生对避孕服务设定的父母同意要求在一定程度上与州政策有关。在那些明确授权未成年人自行同意接受计划生育服务的州,75%为青少年提供避孕服务的医生会在未婚未成年人自行同意的情况下为其提供服务,而在没有明确的未成年人同意法律的州,这一比例为62%。在西南部执业的医生最有可能为18岁以下的未婚患者提供避孕服务,而在北部执业的医生最不可能这么做(分别为88%和67%)。为青春期女性开避孕药的私人医生中,90%会开避孕药片,但提供子宫托或宫内节育器的比例较小(分别为61%和23%)。在接受调查的医生中,青少年初次避孕就诊(包括实验室检查)平均需支付的费用为37美元。在接受青少年避孕患者的医生中,只有53%会接受医疗补助报销,只有1%表示会为无力支付费用的青少年提供免费服务。

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