Access to single-visit IUD insertion at obstetrician-gynecology practices in Ohio: An audit study
| Autor: | JaNelle M. Ricks, Maria F. Gallo, Catherine Romanos, Jaclyn J. Serpico, Wendy G. Smooth, Daniel L. Brook |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Single visit Intrauterine device Logistic regression Appointments and Schedules 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Pregnancy Physicians Humans Medicine 030212 general & internal medicine Ohio Audit study 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Iud insertion Clinic visit Reproductive Medicine Gynecology Family medicine Female business Intrauterine Devices Insurance coverage |
| Zdroj: | Contraception. 102:190-194 |
| ISSN: | 0010-7824 |
| DOI: | 10.1016/j.contraception.2020.05.007 |
| Popis: | Objective Single-visit intrauterine device (IUD) insertion protocols are recommended. We assessed the availability of single-visit IUD insertions, and whether access to these services varies by age, race or parity. Study design Using audit study methodology, we called a random sample of 396 obstetrician-gynecology practices in Ohio while posing as a potential client seeking an IUD insertion appointment. Callers used eight standardized scripts and noted justifications for protocols offered by clinic staff. Practices were randomized to follow a balanced 3×2 factorial design, whereby practices were assigned to one of two conditions: (1) age (18 vs. 30 years of age); (2) race (white vs. black); and (3) parity. Multivariable logistic regression was used to control for clinics rural vs. urban location while considering the effects of these variables on service provision. Results Almost all (95%) of the practices called offered IUD placement, of which 92% required multiple appointments for IUD insertion. Although access to single-visit IUD services did not vary by age or race, we found that parity was associated with clinics’ willingness to schedule a single-visit insertion visit (OR = 3.84, 95% CI = 1.23, 12.04). The most frequent justification provided by clinic staff for their multiple-appointment protocol was the need to verify insurance coverage or order the device directly through the patient’s insurance company. Conclusion Ohio patients seeking IUD placement must typically make more than one clinic visit. Implications Efforts are needed to reassure Ohio clinics that IUDs are routinely covered by insurers and to increase access to same-day IUD placement for women in Ohio, as the requirement to attend multiple clinics appointments to obtain a desired contraceptive may pose an insurmountable barrier to care for those with the fewest resources. |
| Databáze: | OpenAIRE |
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