IUD services among primary care practices in New York City

Laura Jacobson, Samantha Garbers, Hannah Helmy, Hope Roobol, Julia E. Kohn, Megan L. Kavanaugh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective Intrauterine devices (IUDs) are one of the most effective forms of reversible contraception and can reduce unintended pregnancy rates. We explored practice characteristics associated with IUD services across a network of primary care practices in New York City during 2010-2013. Study Design Data were extracted from electronic health records (EHRs) for 253 primary care practices participating in an EHR quality improvement program in New York City. We used diagnostic and procedure codes to count IUD insertions and removals among females aged 10-49 years during 2010-2013. Logistic regression models predicted the likelihood of IUD insertion, removal or no activity for 2013, based on practice characteristics. We stratified trends in IUD services over time by practice type and specialty. Results From 2010 to 2013, the proportion of practices that inserted IUDs increased slightly from 4.7% to 6.3% (p=0.17), and the proportion removing IUDs increased from 8.3% to 12.3% (p 66% female patients had higher odds of performing both insertions and removals. Conclusions From 2010 to 2013, IUD services increased but remained low among primary care practices in this network. Provider training and system readiness programs should include independent primary care practices, which rarely provide IUDs, to ensure that women can receive IUDs or IUD service referrals in the primary care setting. Implications Much of primary care in the United States takes place in independent practices with one or two providers. Our study of a major urban area found that these types of practices are much less likely to offer IUD services than community health centers. Ensuring that small practices know where to refer women for IUD insertion and removal services is warranted to ensure women's access to IUDs.

Original languageEnglish (US)
Pages (from-to)257-262
Number of pages6
JournalContraception
Volume93
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Intrauterine Devices
Primary Health Care
Device Removal
Electronic Health Records
Logistic Models
Community Health Centers
Pregnancy Rate
Quality Improvement
Contraception

Keywords

  • Intrauterine device
  • IUD
  • LARC
  • Long-acting reversible contraception
  • Primary care

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Jacobson, L., Garbers, S., Helmy, H., Roobol, H., Kohn, J. E., & Kavanaugh, M. L. (2016). IUD services among primary care practices in New York City. Contraception, 93(3), 257-262. https://doi.org/10.1016/j.contraception.2015.11.002

IUD services among primary care practices in New York City. / Jacobson, Laura; Garbers, Samantha; Helmy, Hannah; Roobol, Hope; Kohn, Julia E.; Kavanaugh, Megan L.

In: Contraception, Vol. 93, No. 3, 01.03.2016, p. 257-262.

Research output: Contribution to journalArticle

Jacobson, L, Garbers, S, Helmy, H, Roobol, H, Kohn, JE & Kavanaugh, ML 2016, 'IUD services among primary care practices in New York City', Contraception, vol. 93, no. 3, pp. 257-262. https://doi.org/10.1016/j.contraception.2015.11.002
Jacobson L, Garbers S, Helmy H, Roobol H, Kohn JE, Kavanaugh ML. IUD services among primary care practices in New York City. Contraception. 2016 Mar 1;93(3):257-262. https://doi.org/10.1016/j.contraception.2015.11.002
Jacobson, Laura ; Garbers, Samantha ; Helmy, Hannah ; Roobol, Hope ; Kohn, Julia E. ; Kavanaugh, Megan L. / IUD services among primary care practices in New York City. In: Contraception. 2016 ; Vol. 93, No. 3. pp. 257-262.
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abstract = "Objective Intrauterine devices (IUDs) are one of the most effective forms of reversible contraception and can reduce unintended pregnancy rates. We explored practice characteristics associated with IUD services across a network of primary care practices in New York City during 2010-2013. Study Design Data were extracted from electronic health records (EHRs) for 253 primary care practices participating in an EHR quality improvement program in New York City. We used diagnostic and procedure codes to count IUD insertions and removals among females aged 10-49 years during 2010-2013. Logistic regression models predicted the likelihood of IUD insertion, removal or no activity for 2013, based on practice characteristics. We stratified trends in IUD services over time by practice type and specialty. Results From 2010 to 2013, the proportion of practices that inserted IUDs increased slightly from 4.7{\%} to 6.3{\%} (p=0.17), and the proportion removing IUDs increased from 8.3{\%} to 12.3{\%} (p 66{\%} female patients had higher odds of performing both insertions and removals. Conclusions From 2010 to 2013, IUD services increased but remained low among primary care practices in this network. Provider training and system readiness programs should include independent primary care practices, which rarely provide IUDs, to ensure that women can receive IUDs or IUD service referrals in the primary care setting. Implications Much of primary care in the United States takes place in independent practices with one or two providers. Our study of a major urban area found that these types of practices are much less likely to offer IUD services than community health centers. Ensuring that small practices know where to refer women for IUD insertion and removal services is warranted to ensure women's access to IUDs.",
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