Barriers to health care and protocol-based treatment of ectopic pregnancy.
OBJECTIVE
To evaluate whether treatment provided for ectopic pregnancies was different for patients with identified barriers to health care, including ethnicity, lack of insurance, distance from the treating facility that provides services and undocumented residency, at an institution that utilizes a protocol-based algorithm for treatment of ectopic pregnancies.


METHODS
Charts of 401 patients who were diagnosed with ectopic pregnancy from January 1, 1993, through December 31, 1998, were reviewed to compare the use of medical treatment using methotrexate versus surgical treatment. Data were analyzed with respect to patient ethnicity, socioeconomic status (including insurance status and possession of a social security card [a proxy for legal residency status]), residence inside or outside the county of the treating facility, patient presentation and treatment outcomes.


RESULTS
There was no difference in treatment modality or success of primary treatment for ectopic pregnancies between groups regardless of ethnicity, health care insurance, residence outside the county the treating facility was located in or possession of a social security number.


CONCLUSIONS
The treatment of ectopic pregnancies at the University of New Mexico Health Sciences Center is consistent across ethnic and socioeconomic populations. A well-designed treatment protocol may help provide evidenced-based, consistent treatment for patients requiring care who also have identified barriers to medical and surgical treatment.
Lewis
Cindi
C
Department of Obstetrics and Gynecology, University of New Mexico Health Science Center, Albuquerque, NM 87131-001, USA.
Martinez
Carla
C
Rogers
Rebecca
R
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D002985:Clinical Protocols / Q000592:standards; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D017057:Medically Uninsured; D008727:Methotrexate / Q000627:therapeutic use; D009516:New Mexico; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000208:ethnology* / Q000628:therapy*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate