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How often do physicians address other medical problems while providing prenatal care?
1The Lancaster General Research Institute, and the Department of Family and Community Medicine, Lancaster General Hospital, Lancaster, Pennsylvania 17604, USA. docohen@lancastergeneral.org
Annals of Family Medicine
|March 11, 2009
Summary
Family physicians address more nonobstetric diagnoses during prenatal care than obstetricians. This comprehensive approach improves women's access to primary care.
Area of Science:
- Primary Care
- Obstetrics and Gynecology
- Health Services Research
Background:
- Prenatal care often involves addressing multiple health issues.
- The extent to which physicians manage nonobstetric diagnoses during prenatal visits is not well understood.
- Comparing care patterns between family physicians and obstetricians is crucial for understanding healthcare delivery.
Purpose of the Study:
- To quantify the percentage of prenatal visits involving nonobstetric diagnoses managed by physicians.
- To compare the rates of addressing secondary and tertiary nonobstetric diagnoses between family physicians and obstetricians.
- To identify practice patterns in comprehensive prenatal care.
Main Methods:
- Analysis of the National Ambulatory Medical Care Survey (1995-2004).
- Inclusion of prenatal visits to family physicians and obstetricians.
- Outcome measure: percentage of prenatal encounters with one or more nonobstetric diagnoses.
Main Results:
- A total of 6,203 visit records were analyzed, representing millions of patient encounters.
- Family physicians addressed nonobstetric diagnoses in 17.6% of prenatal visits, compared to 7.8% for obstetricians (P < .01).
- Family physicians were independently associated with a higher likelihood of managing nonobstetric diagnoses during prenatal care (OR = 2.57).
Conclusions:
- Family physicians frequently diagnose and manage nonobstetric problems during prenatal care, significantly more so than obstetricians.
- This practice by family physicians contributes to enhanced access to comprehensive primary care for women.
- Findings highlight differences in care scope between family physicians and obstetricians in prenatal settings.
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