The 130th Annual Meeting of APHA

4170.0: Tuesday, November 12, 2002 - 1:45 PM

Abstract #44860

Impact of "one-stop" comprehensive care on the quality of care for minority women

Julie B. Rabinovitz, MPH, Office for Women, Family and Community Programs, Brigham and Women's Hospital, 75 Francis Street, NH202, Boston, MA 02115, 617-732-5756, jrabinovitz@partners.org, JudyAnn Bigby, MD, Brigham and Women's Hospital, Harvard Medical School's Center of Excellence in Women's Health, 75 Francis Street, Neville - 2, Boston, MA 02115, Jennifer Potter, MD, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, Karen Carlson, MD, Women's Health Associates, Massachusetts General Hospital, 55 Fruit Street, Blake 10, Boston, MA 02114, Heidi Behforouz, MD, Women's Health Associates, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, and Paula A. Johnson, MD, MPH, Division of Women's Health, Brigham and Women's Hospital, 75 Francis Street, PBB4, Boston, MA 02115.

While early studies suggest that integrated, comprehensive services for women – “one-stop shopping” - result in improved provision of preventative care for white women (WW), this model has not been evaluated for black and Latina women (MW). A retrospective cohort study was performed to evaluate differences in the process of care for WW and MW in traditional primary care and women’s health faculty practices in urban teaching hospitals. Initial data from a preliminary population of 387 women, aged 45-64 years (45% black, 11% Hispanic, and 44% white) indicate that MW have higher rates of hypertension and diabetes. MW are less likely to have LDL screening, even when they have known coronary heart disease (CHD). MW are less likely to have had breast cancer, and are more likely to have a mammogram than WW. MW and WW have similar rates of Pap smears; past CHD and cervical cancer; low documented rates of domestic violence (DV) screening; and high rates of breast and cervical cancer screening and follow-up of abnormal results. These initial data indicate that attention to breast and cervical cancer screening does not guarantee attention to other important health issues in middle-aged women. Focus on risk reduction for CHD, especially in high-risk populations such as MW, is necessary to improve compliance with published guidelines. Similarly, the screening rates for DV are remarkably low, and need to be improved. The high prevalence of co-morbid illnesses among middle-aged MW requires monitoring for quality of care that goes beyond breast and cervical cancer screenings.

Learning Objectives:

Keywords: Women's Quality Care, Women's Health

Presenting author's disclosure statement:
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.

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The 130th Annual Meeting of APHA