A Population-Based Study of US Women's Preferred versus Usual Sources of Reproductive Health Care

Among women reporting health service utilization (92% overall; 77% Papanicolaou/pelvic; 33% contraception; 8% STI), women's health specialists were the most used sources of care for Papanicolaou/pelvic (68%), contraception (74%), and STI (75%) services. Women's health specialists were also the most preferred care sources for Papanicolaou/pelvic (68%), contraception (49%), and STI (35%) services, whereas the remainder of women preferred primary care/other sources or not to get care. Differences in preferred and usual care sources were noted across sociodemographic groups, including insurance status and income level. 

Preference for women's health specialists was the strongest predictor of women's health specialist utilization for Papanicolaou/pelvic and contraceptive services. Agreement between preferred and usual-care sources was high for Papanicolaou/pelvic and contraception services; disagreement was associated with insurance, employment, income, race, and religion.

Women's preferences for and use of women's health specialists for reproductive health care has implications for efforts to define the role of obstetricians-gynecologists and family planning clinics in current health systems.

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By: Hall KS1, Patton EW2, Crissman HP3, Zochowski MK4, Dalton VK5.

• 1Department of Obstetrics and Gynecology, Institute for Social Research, University of Michigan, Ann Arbor, MI.
• 2Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI.
• 3School of Medicine, University of Michigan, Ann Arbor, MI.
• 4Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
• 5Department of Obstetrics and Gynecology, Program on Women's Health Care Effectiveness Research, and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.