Trends in office-based care for reproductive-aged women according to physician specialty: a ten-year study

Abstract

Background: The anticipated increase in access to health care has prompted an interest in where women go for their office-based care. The objectives of this study were to examine which types of office site are chosen by reproductive-aged women for their health care and to compare the reasons for their visits among these sites.

Methods: This descriptive study involved an analysis of national data from the Medical Expenditure Panel Survey between 2002 and 2011. We restricted the analysis to a nationally representative group of women between 19 and 39 years old (n=45,133). Interviews with patients were used to identify the patient's demographics, type of physician seen, and main reason for each self-reported office visit (n=208,814).

Results: One in four women did not go to a physician's office each year. Nearly all who sought some sort of office-based care went to family physicians, ob-gyns, or a combination. For the women who did go to a physician's office, going only to a family physician's office was most common (42.6%). In contrast, 28.6% of these women visited only an ob-gyn office, and an additional 21.5% went to offices of a family physician or general internist as well as an ob-gyn physician. Visits only to offices of ob-gyns were highest among women who were married and healthy. Compared with family physicians or internists, the percentages of office visits to an ob-gyn were more likely for pregnancy (57.0% vs. 2.8%), about the same for a general check-up (23.6% vs. 29.2%), and less for diagnosis or treatment (13.7% vs. 55.5%). Those who went to ob-gyn offices were most apt to return for several visits per year.

Conclusion: Almost all health care sought by women aged 19 to 39 in a year is to ob-gyns or family physicians, and significant sharing of care exists across these provider groups. While most visits to family physicians were for diagnosis or treatment, the majority of visits to ob-gyn were for pregnancy-related care.