Context of care and contraceptive method use.
OBJECTIVE
We assessed the relationship between context of care (incorporates insurance status with clinical setting) on contraceptive use among a national sample of reproductive-aged women. Our hypothesis is that compared to privately insured women who receive their health care in private doctors' offices, women who are publicly insured or self-pay and/or receive their health care in a clinic are more likely to use permanent or long-acting contraceptive methods.


METHODS
The study population, consisting of 4,358 women surveyed as part of the 1995 National Survey of Family Growth (NSFG) who were both at risk of unintended pregnancy and currently sexually active, was analyzed using polytomous logistic regression.


RESULTS
Following adjustment for age, race/ethnicity, marital status, education, income, parity and smoking, there was a trend toward long-acting contraceptive use among women with public insurance or who were self-pay, regardless of clinical setting compared to privately insured women seen in private clinics. Self-pay and publicly insured women of low parity tended to use long-acting contraception, as did privately insured women seen in clinics.


CONCLUSIONS
Insurance information, as well as clinical setting, may guide clinicians' contraceptive decision-making.
Boardman
Lori A
LA
Division of Ambulatory Care, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Providence, Rhode Island, USA. lboardma@wihri.org
Weitzen
Sherry
S
Lapane
Kate L
KL
D000328:Adult; D001294:Attitude to Health; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016015:Logistic Models; D017057:Medically Uninsured / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017149:Private Sector / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D017150:Public Sector / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D016387:Women's Health; D014932:Women's Health Services / Q000706:statistics & numerical data*
D003271:Contraceptive Agents, Female