5150.0: Wednesday, November 15, 2000 - 12:30 PM

Abstract #11991

The silent consumer: Access to and satisfaction with pregnancy termination services

Jane G. Zapka, ScD1, Stephenie Lemon, MS1, Laura E. Peterson, BSN, SM2, Heather Palmer, MBBCh, SM2, and Marlene B. Goldman, ScD3. (1) Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, (508)856-5675, jane.zapka@umassmed.edu, (2) Center for Quality of Care Research and Education, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, (3) Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115

Despite established guidelines and proven safety of surgically induced abortion procedures, little is known about access to and satisfaction with services. A survey of 797 women who received abortions at two New England health centers was conducted. One center was staffed by female physician assistants, the other by a male physician. Demographic and pregnancy history factors, post-procedure complications, barriers to access, and satisfaction with several dimensions of clinical care were assessed. Logistic regression examined the associations of variables with global measures of satisfaction. Access difficulties and complications were infrequent, while satisfaction with service dimensions was very positive; 95% strongly agreed or agreed that care was excellent, while only 17% agreed or strongly agreed that the care they received could have been better. Strong agreement that care received was excellent was positively associated with older age, more prior births, living out-of-state, reporting difficulties in finding a place to have the procedure, positive ratings of the clinic environment, staff sensitivity and the information provided, and disagreement with feeling being made to "jump through hoops". Women who agreed that care could have been better were more likely to have had an early uterine evacuation procedure, feel too much time was spent waiting, have had a medical complication, agree that there was too much counseling emphasis and report lower ratings of staff sensitivity and information provided. Site of care was not a predictor of satisfaction. This study highlights the powerful role of education and counseling and suggests areas to consider in quality improvement efforts.

Learning Objectives: 1. Understand dimensions of care which could be considered in quality improvement efforts in pregnancy termination services. 2. Describe women's reports and ratings of access to and satisfaction with pregnancy termination services. 3. Articulate the access and service variables most strongly related to general satisfaction with pregnancy termination services

Keywords: Access and Services, Patient Satisfaction

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA