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A randomized controlled trial of direct access for laparoscopic sterilization
L McKessock1, B H Smith, A Scott
1Dugald Baird Centre for Research on Women's Health, University of Aberdeen, UK.
Family Practice
|January 6, 2001
Summary
Direct access sterilization services were evaluated. While medical professionals supported it, patients preferred routine referral, with no significant differences in satisfaction or costs.
Area of Science:
- Reproductive Health
- Health Services Research
- Surgical Procedures
Background:
- Direct access services aim to streamline patient care pathways.
- Evaluating new models for gynecological procedures is crucial for healthcare efficiency.
Purpose of the Study:
- To establish and assess a direct access service for laparoscopic sterilization.
- To compare patient and provider outcomes between direct and routine referral for sterilization.
Main Methods:
- A pragmatic randomized controlled trial involving 232 women undergoing sterilization.
- Assessed outcomes included waiting times, patient/doctor satisfaction, complications, costs, and preferences.
Main Results:
- No inappropriate direct referrals occurred; waiting times were reduced in the direct access group.
- Patient and doctor satisfaction remained high in both groups, with no difference in complications or costs.
- Patients preferred routine referral, valuing information over shorter waiting times; only 31% were suitable for direct referral.
Conclusions:
- Patients preferred traditional routine referral despite medical support for direct access.
- Restrictive criteria may hinder direct access uptake, necessitating careful service planning.
- Methodological insights were gained for trials at the primary-secondary care interface.