U.S. Women's Intended Sources for Reproductive Health Care.
BACKGROUND
The current sociopolitical climate and context of the Affordable Care Act have led some to question the future role of family planning clinics in reproductive health care. We explored where women plan to get their future contraception, pelvic exam/pap smears, and sexually transmitted infection testing, with a focus on the role of family planning clinics.


METHODS
Data were drawn from a study of United States adults conducted in January 2013 from a national online panel. We focused on English-literate women aged 18-45 years who answered items on intended sources of care (private office/health maintenance organization [HMO], family planning clinic, other, would not get care) for reproductive health services. We used Rao-Scott F tests to compare intended sources across sociodemographic groups, and logistic regression to model odds of intending to use family planning clinics. Probability weights were used to adjust for the complex sampling design.


RESULTS
The response rate was 61% (n = 2,182). Of the 723 respondents who met the inclusion criteria, approximately half intended to use private offices/HMOs. Among some subgroups, including less educated (less than high school), lower annual incomes (<$25,000) and uninsured women, the proportion intending to use family planning clinics was higher than the proportion intending to use private office/HMO in unadjusted analyses. Across all service types, unmarried and uninsured status were associated with intention to use family planning clinics in multivariable models.


CONCLUSIONS
While many women intend to use private offices/HMOs for their reproductive health care, family planning clinics continue to play an important role, particularly for socially disadvantaged women.
1 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
Halley P
HP
Crissman
2 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Kelli Stidham
KS
Hall
1 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
Elizabeth W
EW
Patton
1 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
Melissa K
MK
Zochowski
3 Department of Pediatrics and Communicable Diseases, University of Michigan , Ann Arbor, Michigan.
Matthew M
MM
Davis
1 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
Vanessa K
VK
Dalton
D000293:Adolescent; D000328:Adult; D003191:Comprehensive Health Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D017149:Private Sector; D017150:Public Sector; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014932:Women's Health Services / Q000706:statistics & numerical data*