Women's Preferred Sources for Primary and Mental Health Care: Implications for Reproductive Health Providers.
To describe women's preferences for reproductive health providers as sources of primary and mental health care.



This is secondary data analysis of the Women's Health Care Experiences and Preferences Study, an Internet survey conducted in September 2013 of 1,078 women aged 18 to 55 randomly sampled from a U.S. national probability panel. We estimated women's preferred and usual sources of care (reproductive health providers, generalists, other) for various primary care and mental health care services using weighted statistics and multiple logistic regression.



Among women using health care in the past 5 years (n = 981), 88% received primary and/or mental health care, including a routine medical checkup (78%), urgent/acute (48%), chronic disease (27%), depression/anxiety (21%), stress (16%), and intimate partner violence (2%) visits. Of those, reproductive health providers were the source of checkup (14%), urgent/acute (3%), chronic disease (6%), depression/anxiety (6%), stress (11%), and intimate partner violence (3%) services. Preference for specific reproductive health-provided primary/mental health care services ranged from 7% to 20%. Among women having used primary/mental health care services (N = 894), more women (1%-17%) preferred than had received primary/mental health care from reproductive health providers. Nearly one-quarter (22%) identified reproductive health providers as their single most preferred source of care. Contraceptive use was the strongest predictor of preference for reproductive health-provided primary/mental health care (odds ratios range, 2.11-3.30).



Reproductive health providers are the sole source of health care for a substantial proportion of reproductive-aged women-the same groups at risk for unmet primary and mental health care needs. Findings have implications for reproductive health providers' role in comprehensive women's health care provision and potentially for informing patient-centered, integrated models of care in current health systems.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan. Electronic address: kelli.s.hall@emory.edu.
Kelli Stidham
KS
Hall
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; Department of Women's Studies, University of Michigan, Women's Hospital, Ann Arbor, Michigan.
Lisa H
LH
Harris
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
Vanessa K
VK
Dalton
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008605:Mental Health Services; D008875:Middle Aged; D057240:Patient Preference; D011320:Primary Health Care; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D014481:United States; D014932:Women's Health Services; D055815:Young Adult