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

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. KEYWORDS chronic conditions, physician specialty, preventive care, reproductive health, women's health What is known on this topic * A substantial proportion of reproductive-age women receive preventive care from obstetrician-gynecologists * The prevalence of chronic conditions among US adults is high, including among reproductive-age women * Provision of specific services in preventive visits may vary by physician specialty and patient chronic condition status What this study adds * OB/GYN preventive care visits include more reproductive-related services and fewer other services relative to generalist physicians, including for patients with chronic conditions * Preventive visits with OB/GYNs were shorter on average than preventive visits with generalist physicians * Better understanding the full range of care received in preventive visits across settings by reproductive-age women with chronic conditions can help guide recommendations to optimize where this population seeks care
1 | INTRODUCTION Preventive care is important for optimal health, (1) and the Affordable Care Act required that insurance plans cover certain preventive services with no cost sharing starting in [...]