A missed opportunity for care: two-visit IUD insertion protocols inhibit placement
Abstract Background The intrauterine device (IUD) is a safe, long-acting, highly effective method of birth control. Two-visit protocols for IUD insertion may represent a barrier to IUD uptake. Study Design This study is a retrospective database review. We identified Medicaid-insured women who reques...
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| Veröffentlicht in: | Contraception (Stoneham) 2012-12, Vol.86 (6), p.694-697 |
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| creator | Bergin, Ashlee Tristan, Sigrid Terplan, Mishka Gilliam, Melissa L Whitaker, Amy K |
| description | Abstract Background The intrauterine device (IUD) is a safe, long-acting, highly effective method of birth control. Two-visit protocols for IUD insertion may represent a barrier to IUD uptake. Study Design This study is a retrospective database review. We identified Medicaid-insured women who requested IUDs in our urban university-based clinic, which employed a two-visit protocol for IUD insertion. The number of women who returned for IUD insertion was determined. To compare women who underwent insertion to those who did not, bivariate and multivariable analyses were used. Results Of the 708 women who requested IUDs at the initial visit, only 385 had an IUD inserted (54.4%). Single women were less likely to return for IUD placement compared to women who had ever been married (52.4% vs. 70.3%; p |
| doi_str_mv | 10.1016/j.contraception.2012.05.011 |
| format | Article |
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Two-visit protocols for IUD insertion may represent a barrier to IUD uptake. Study Design This study is a retrospective database review. We identified Medicaid-insured women who requested IUDs in our urban university-based clinic, which employed a two-visit protocol for IUD insertion. The number of women who returned for IUD insertion was determined. To compare women who underwent insertion to those who did not, bivariate and multivariable analyses were used. Results Of the 708 women who requested IUDs at the initial visit, only 385 had an IUD inserted (54.4%). Single women were less likely to return for IUD placement compared to women who had ever been married (52.4% vs. 70.3%; p<.01). Patients who ordered IUDs at gynecologic visits were more likely to return as opposed to those who had them ordered at obstetrics-related visits (60.5% vs. 50.2%; p<.01). Women who lived > 10 miles away from the clinic were less likely to return for IUD insertion than women who lived < 10 miles away from the clinic (45.3% vs. 56.2%; p=.03). Race, age and type of IUD ordered were not significantly associated with probability of insertion. Conclusions Almost half of women who ordered IUDs did not return for insertion, suggesting that two-visit protocols hinder a woman's ability to have an IUD placed. We must eliminate barriers to IUD insertion.</description><identifier>ISSN: 0010-7824</identifier><identifier>EISSN: 1879-0518</identifier><identifier>DOI: 10.1016/j.contraception.2012.05.011</identifier><identifier>PMID: 22770798</identifier><identifier>CODEN: CCPTAY</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Barriers ; Biological and medical sciences ; Chicago ; Contraception Behavior ; Female ; Genital system. Reproduction ; Gynecology. Andrology. Obstetrics ; Health Services Accessibility ; Hospitals, University ; Hospitals, Urban ; Humans ; Indexing in process ; Intrauterine Devices, Medicated - utilization ; IUD (intrauterine device) insertion ; Marital Status ; Medicaid ; Medical sciences ; Obstetrics and Gynecology ; Office Visits ; Outpatient Clinics, Hospital ; Patient Acceptance of Health Care ; Pharmacology. Drug treatments ; Postpartum Period ; Residence Characteristics ; Retrospective Studies ; Two-visit protocol ; United States ; Urban ; Urban Health ; Young Adult</subject><ispartof>Contraception (Stoneham), 2012-12, Vol.86 (6), p.694-697</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c600t-b6cd5a85e0e16a694898f04daa6a6e6005b104e424ae0d36e681535d2937c0a63</citedby><cites>FETCH-LOGICAL-c600t-b6cd5a85e0e16a694898f04daa6a6e6005b104e424ae0d36e681535d2937c0a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.contraception.2012.05.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26650879$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22770798$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bergin, Ashlee</creatorcontrib><creatorcontrib>Tristan, Sigrid</creatorcontrib><creatorcontrib>Terplan, Mishka</creatorcontrib><creatorcontrib>Gilliam, Melissa L</creatorcontrib><creatorcontrib>Whitaker, Amy K</creatorcontrib><title>A missed opportunity for care: two-visit IUD insertion protocols inhibit placement</title><title>Contraception (Stoneham)</title><addtitle>Contraception</addtitle><description>Abstract Background The intrauterine device (IUD) is a safe, long-acting, highly effective method of birth control. Two-visit protocols for IUD insertion may represent a barrier to IUD uptake. Study Design This study is a retrospective database review. We identified Medicaid-insured women who requested IUDs in our urban university-based clinic, which employed a two-visit protocol for IUD insertion. The number of women who returned for IUD insertion was determined. To compare women who underwent insertion to those who did not, bivariate and multivariable analyses were used. Results Of the 708 women who requested IUDs at the initial visit, only 385 had an IUD inserted (54.4%). Single women were less likely to return for IUD placement compared to women who had ever been married (52.4% vs. 70.3%; p<.01). Patients who ordered IUDs at gynecologic visits were more likely to return as opposed to those who had them ordered at obstetrics-related visits (60.5% vs. 50.2%; p<.01). Women who lived > 10 miles away from the clinic were less likely to return for IUD insertion than women who lived < 10 miles away from the clinic (45.3% vs. 56.2%; p=.03). Race, age and type of IUD ordered were not significantly associated with probability of insertion. Conclusions Almost half of women who ordered IUDs did not return for insertion, suggesting that two-visit protocols hinder a woman's ability to have an IUD placed. We must eliminate barriers to IUD insertion.</description><subject>Adult</subject><subject>Barriers</subject><subject>Biological and medical sciences</subject><subject>Chicago</subject><subject>Contraception Behavior</subject><subject>Female</subject><subject>Genital system. Reproduction</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Health Services Accessibility</subject><subject>Hospitals, University</subject><subject>Hospitals, Urban</subject><subject>Humans</subject><subject>Indexing in process</subject><subject>Intrauterine Devices, Medicated - utilization</subject><subject>IUD (intrauterine device) insertion</subject><subject>Marital Status</subject><subject>Medicaid</subject><subject>Medical sciences</subject><subject>Obstetrics and Gynecology</subject><subject>Office Visits</subject><subject>Outpatient Clinics, Hospital</subject><subject>Patient Acceptance of Health Care</subject><subject>Pharmacology. Drug treatments</subject><subject>Postpartum Period</subject><subject>Residence Characteristics</subject><subject>Retrospective Studies</subject><subject>Two-visit protocol</subject><subject>United States</subject><subject>Urban</subject><subject>Urban Health</subject><subject>Young Adult</subject><issn>0010-7824</issn><issn>1879-0518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkm1rFDEQx4Mo9lr9CrIggm92O8lu9kGhUGprC4WC2tchl53FnHvJmmQr9-2d5U5F39hXSSa_efrPMPaaQ8GB16ebwniXgjY4JetdIYCLAmQBnD9hK942XQ6St0_ZCoBD3rSiOmLHMW4AoOlk85wdCdE0dG9X7NN5trUxYp_5afIhzc6mXTb4kBkd8F2Wfvj8wUabspv7D5l1EcOSNJuCT974MZLtq13T_zRSRVt06QV7Nugx4svDecLury6_XFznt3cfby7Ob3NTA6R8XZte6lYiIK913VVt1w5Q9VrTCwmRaw4VVqLSCH1JppbLUvaiKxsDui5P2Nt9XKrl-4wxKerE4Dhqh36OiotGNLwDaP-P8rKredeVgtD3e9QEH2PAQU3BbnXYKQ5q0V9t1F_6q0V_BVKR_uT96pBoXm-x_-37S3AC3hwAHY0eh6CdsfEPV9cSaILEXe45JAUfLAYVjUVnsLcBTVK9t48s6OyfOGa0zlLqb7jDuPFzcDQkxVUkH_V5WZllY7gAEDSE8idPHr_T</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Bergin, Ashlee</creator><creator>Tristan, Sigrid</creator><creator>Terplan, Mishka</creator><creator>Gilliam, Melissa L</creator><creator>Whitaker, Amy K</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7ST</scope><scope>7U6</scope><scope>C1K</scope></search><sort><creationdate>20121201</creationdate><title>A missed opportunity for care: two-visit IUD insertion protocols inhibit placement</title><author>Bergin, Ashlee ; Tristan, Sigrid ; Terplan, Mishka ; Gilliam, Melissa L ; Whitaker, Amy K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c600t-b6cd5a85e0e16a694898f04daa6a6e6005b104e424ae0d36e681535d2937c0a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Barriers</topic><topic>Biological and medical sciences</topic><topic>Chicago</topic><topic>Contraception Behavior</topic><topic>Female</topic><topic>Genital system. Reproduction</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Health Services Accessibility</topic><topic>Hospitals, University</topic><topic>Hospitals, Urban</topic><topic>Humans</topic><topic>Indexing in process</topic><topic>Intrauterine Devices, Medicated - utilization</topic><topic>IUD (intrauterine device) insertion</topic><topic>Marital Status</topic><topic>Medicaid</topic><topic>Medical sciences</topic><topic>Obstetrics and Gynecology</topic><topic>Office Visits</topic><topic>Outpatient Clinics, Hospital</topic><topic>Patient Acceptance of Health Care</topic><topic>Pharmacology. Drug treatments</topic><topic>Postpartum Period</topic><topic>Residence Characteristics</topic><topic>Retrospective Studies</topic><topic>Two-visit protocol</topic><topic>United States</topic><topic>Urban</topic><topic>Urban Health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bergin, Ashlee</creatorcontrib><creatorcontrib>Tristan, Sigrid</creatorcontrib><creatorcontrib>Terplan, Mishka</creatorcontrib><creatorcontrib>Gilliam, Melissa L</creatorcontrib><creatorcontrib>Whitaker, Amy K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Environment Abstracts</collection><collection>Sustainability Science Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Contraception (Stoneham)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bergin, Ashlee</au><au>Tristan, Sigrid</au><au>Terplan, Mishka</au><au>Gilliam, Melissa L</au><au>Whitaker, Amy K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A missed opportunity for care: two-visit IUD insertion protocols inhibit placement</atitle><jtitle>Contraception (Stoneham)</jtitle><addtitle>Contraception</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>86</volume><issue>6</issue><spage>694</spage><epage>697</epage><pages>694-697</pages><issn>0010-7824</issn><eissn>1879-0518</eissn><coden>CCPTAY</coden><abstract>Abstract Background The intrauterine device (IUD) is a safe, long-acting, highly effective method of birth control. Two-visit protocols for IUD insertion may represent a barrier to IUD uptake. Study Design This study is a retrospective database review. We identified Medicaid-insured women who requested IUDs in our urban university-based clinic, which employed a two-visit protocol for IUD insertion. The number of women who returned for IUD insertion was determined. To compare women who underwent insertion to those who did not, bivariate and multivariable analyses were used. Results Of the 708 women who requested IUDs at the initial visit, only 385 had an IUD inserted (54.4%). Single women were less likely to return for IUD placement compared to women who had ever been married (52.4% vs. 70.3%; p<.01). Patients who ordered IUDs at gynecologic visits were more likely to return as opposed to those who had them ordered at obstetrics-related visits (60.5% vs. 50.2%; p<.01). Women who lived > 10 miles away from the clinic were less likely to return for IUD insertion than women who lived < 10 miles away from the clinic (45.3% vs. 56.2%; p=.03). Race, age and type of IUD ordered were not significantly associated with probability of insertion. Conclusions Almost half of women who ordered IUDs did not return for insertion, suggesting that two-visit protocols hinder a woman's ability to have an IUD placed. We must eliminate barriers to IUD insertion.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22770798</pmid><doi>10.1016/j.contraception.2012.05.011</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Barriers Biological and medical sciences Chicago Contraception Behavior Female Genital system. Reproduction Gynecology. Andrology. Obstetrics Health Services Accessibility Hospitals, University Hospitals, Urban Humans Indexing in process Intrauterine Devices, Medicated - utilization IUD (intrauterine device) insertion Marital Status Medicaid Medical sciences Obstetrics and Gynecology Office Visits Outpatient Clinics, Hospital Patient Acceptance of Health Care Pharmacology. Drug treatments Postpartum Period Residence Characteristics Retrospective Studies Two-visit protocol United States Urban Urban Health Young Adult |
| title | A missed opportunity for care: two-visit IUD insertion protocols inhibit placement |
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