Literature DB >> 10632828

Delivery of primary care to women. Do women's health centers do it better?

E A Phelan1, W Burke, R A Deyo, T D Koepsell, A Z LaCroix.   

Abstract

OBJECTIVE: Women's health centers have been increasing in number but remain relatively unstudied. We examined patient expectations and quality of care at a hospital-based women's health center compared with those at a general medicine clinic.
DESIGN: Cross-sectional survey.
SETTING: University hospital-affiliated women's health and general internal medicine clinics. PARTICIPANTS: An age-stratified random sample of 2,000 women over 18 years of age with at least two visits to either clinic in the prior 24 months. We confined the analysis to 706 women respondents who identified themselves as primary care patients of either clinic.
MEASUREMENTS AND MAIN RESULTS: Personal characteristics, health care utilization, preferences and expectations for care, receipt of preventive services, and satisfaction with provider and clinic were assessed for all respondents. Patients obtaining care at the general internal medicine clinic were older and had more chronic diseases and functional limitations than patients receiving care at the women's health center. Women's health center users (n = 357) were more likely than general medicine clinic users ( n = 349) to prefer a female provider ( 57% vs 32%, p =.0001) and to have sought care at the clinic because of its focus on women's health (49% vs 17%, p =. 0001). After adjusting for age and self-assessed health status, women's health center users were significantly more likely to report having had mammography (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.1, 15.2) and cholesterol screening (OR 1.6, 95% CI 1.0, 2.6) but significantly less likely to report having undergone flexible sigmoidoscopy (OR 0.5, 95% CI 0.3, 0.9). There were no significant differences between the clinics on receipt of counseling about hormone replacement therapy or receipt of Pap smear, or in satisfaction.
CONCLUSIONS: These results suggest that, at least in this setting, women's health centers provide care to younger women and those with fewer chronic medical conditions and may meet a market demand. While the quality of gender-specific preventive care may be modestly better in women's health centers, the quality of general preventive care may be better in general medical clinics.

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Mesh:

Year:  2000        PMID: 10632828      PMCID: PMC1495323          DOI: 10.1046/j.1525-1497.2000.12178.x

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


  21 in total

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3.  Women's health centers: history and evolution.

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4.  Measuring physician behavior.

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5.  The National Survey of Women's Health Centers: current models of women-centered care.

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6.  Agreement among physician assessment methods. Searching for the truth among fallible methods.

Authors:  B Gerbert; G Stone; M Stulbarg; D S Gullion; S Greenfield
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8.  Are patients of women physicians screened more aggressively? A prospective study of physician gender and screening.

Authors:  M W Kreuter; V J Strecher; R Harris; S C Kobrin; C S Skinner
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9.  Selected health behaviors and perceptions among U.S. adults in 1990.

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10.  Patterns of breast and cervical cancer screening at three public health centers in an inner-city urban area.

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  3 in total

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Authors:  S D Gharib; J A Manson
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2.  Differences in Burnout and Intent to Leave Between Women's Health and General Primary Care Providers in the Veterans Health Administration.

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3.  Patient satisfaction in women's clinics versus traditional primary care clinics in the Veterans Administration.

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