Obstetrics & Gynecology Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2008;111:945-952
© 2008 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Lewis, B. G.
Right arrow Articles by Federman, A. D.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lewis, B. G.
Right arrow Articles by Federman, A. D.
Related Collections
Right arrow General gynecology
Right arrow General obstetrics
Right arrow Gynecologic surgery
Right arrow Internal Medicine

ORIGINAL RESEARCH

Preventive Services Use Among Women Seen by Gynecologists, General Medical Physicians, or Both

Beth G. Lewis, MD1, Ethan A. Halm, MD, MPH2, Sue M. Marcus, PhD3, Deborah Korenstein, MD2 and Alex D. Federman, MD, MPH2

From the 1Department of Medicine, Saint Peters University Hospital, Drexel University, New Brunswick, New Jersey; 2Division of General Internal Medicine, Mount Sinai School of Medicine, New York, New York; and 3Department of Psychiatry, Mount Sinai School of Medicine, New York, New York.

OBJECTIVE: To estimate how preventive services and counseling differ for women seen by general medical physicians and gynecologists, and whether seeing both types of physicians had a greater impact on delivery of gender-specific and gender-neutral preventive care than by either type of physician alone.

METHODS: Using data from the 2000 National Health Interview Survey, we studied the association of provider type with Pap tests, tobacco use screening, and exercise and diet counseling among women 18–64 years (n=7,317), and these services along with clinical breast examinations, mammograms, and colon cancer screening among women aged 50–64 years (n=1,551). We modeled care using multivariable logistic regression and used propensity score techniques to limit selection bias from choice of provider.

RESULTS: In the study sample, 15% were seen by general medical physicians, 62% by gynecologists, and 23% by both. Overall rates of gender-specific services (Pap test, clinical breast examination, mammography) were high (88–95%), whereas gender-neutral services were low (23–53%). Patients of gynecologists only were more likely to have Pap tests (adjusted relative risk [RR] 1.26, 95% confidence interval [CI] 1.24–1.27), tobacco use screening (adjusted RR 1.08, 95% CI 1.02–1.14), mammography (adjusted RR 1.25, 95% CI 1.20–1.28), and clinical breast examination (adjusted RR 1.25, 95% CI 1.19–1.29). In general, combined gynecologist and general care did not increase the likelihood of preventive care. Propensity score analyses confirmed these results.

CONCLUSION: Patients of gynecologists receive more preventive services compared with patients of general medical physicians, although rates of gender-neutral services were low regardless of provider type. These findings validate gynecologists’ roles as providers of basic preventive care services but demonstrate that considerable room exists to improve delivery of preventive care to women.

LEVEL OF EVIDENCE: III






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American College of Obstetricians and Gynecologists.