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Women's Patterns of Provider Use Across the Lifespan and Satisfaction With Primary Care Coordination and Comprehensiveness

Henderson, Jillian T. PhD, MPH*; Weisman, Carol S. PhD

doi: 10.1097/01.mlr.0000170422.73033.eb
Original Article

Background: Women have different patterns of provider use across the lifespan, but few studies have investigated women's evaluations of their primary care providers at different ages.

Objective: We sought to investigate the relationship between patterns of regular provider use and women's satisfaction with primary care across the lifespan.

Research Design: A sample of 1197 women ages 18 to 87 making primary health care visits was surveyed. Satisfaction with primary care in the past year was measured with a subscale the Care Coordination and Comprehensiveness subscale of the Primary Care Satisfaction Survey for Women (PCSSW). Bivariate comparisons and age stratified multivariate ordinal logistic regression models were estimated.

Results: Women in their early reproductive years (ages 18 to 34) are more satisfied with care coordination and comprehensiveness when their regular provider is a reproductive health specialist, primarily obstetrician gynecologist (ob/gyn) physicians. The odds of higher satisfaction are reduced with a generalist regular provider (OR = 0.38, P < 0.01), a generalist regular provider plus an ob/gyn (OR = 0.47, P < 0.05), or no regular provider (OR = 0.52, P < 0.05). The pattern of regular provider use is not significantly associated with satisfaction for women in other age categories.

Conclusions: Most adult women see generalists for their primary health care, either alone or in combination with ob/gyns. Among younger women satisfaction is higher when an ob/gyn is the regular provider. Further research must consider women's perspectives on their provider use patterns and the appropriate role of ob/gyns in women's primary care across the lifespan.

From the *Center for Reproductive Health Research and Policy, University of California, San Francisco, San Francisco, California; and the †Department of Health Evaluation Sciences and Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania.

Dr. Henderson's work on this study was supported by a training grant from the National Institute on Aging (NIA) [T32-AG00134]. The research project that generated the data for the study was funded by grant number R01 HS10237 from the Agency for Healthcare Research and Quality (AHRQ).

An earlier version of this paper was presented at the AcademyHealth Annual Research Meeting in San Diego on June 6, 2004.

Reprints: Jillian T. Henderson, PhD, MPH, University of California, San Francisco Center for Reproductive Health Research and Policy, 3333 California Street, Ste 335, San Francisco, CA 94143. E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.