268715 Scope of family planning and reproductive health services provided in community health centers

Tuesday, October 30, 2012 : 8:45 AM - 9:00 AM

Susan Wood, PhD , Department of Health Policy, The George Washington University/School of Public Health and Health Services, Washington, DC
Peter Shin, PhD , Department of Health Policy, George Washington University School of Public Health, Washington, DC
Debora Goetz Goldberg, PhD, MBA, MHA , Department of Health POlicy, The George Washington University School of Public Health and Health Services, Washington, DC
Brian Bruen, MS , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Tishra Beeson, MPH , Department of Health Policy, The George Washington University, Washington, DC
Merle Cunningham, MD, MPH , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Kay Johnson, MPH, EdM , Johnson Group Consulting, Hinesburg, VT
Holly Mead, PhD , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Katherine Hayes, JD , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Julie Lewis , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Shavon Artis, MPH , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Xiao Xiao Lu, MPH , Department of Health Policy, The George Washington University School of Public Health and Health Services, Washington, DC
Sara Rosenbaum, JD , Department of Health Policy, George Washington University, Washington, DC, DC
     
Community health centers (termed federally qualified health centers (FQHCs) under Medicare and Medicaid) represent the single largest primary care system in the U.S. In 2010, 1,124 FQHCs provided primary care to approximately 20 million patients across every state, D.C., and U.S. territories. Women comprise 59 percent of health center patients; nearly half are of childbearing age. Virtually all health centers (99 percent) report provision of contraceptive management/birth control or infertility treatment and counseling and education either on-site or through referrals. In 2010, health centers furnished contraceptive management to nearly 1.1 million patients (ICD-9 codes V25.xx) at FQHCs. Until recently, limited data existed on health center family planning practices beyond contraceptive management, nor did data exist on health center contraceptive dispensing practices.

A GW national survey of 958 FQHCs (44% response rate) show that 9 in 10 provide some type of family planning services, with high variation in actual practice. Health centers with a high level of family planning practice engagement (receipt of Title X grants as a marker for high engagement) show a broader scope of services, greater targeting of at-risk populations, and higher degree of confidentiality for adolescents. Health centers in states with ‘friendlier' family planning policies also provide access to broader range of services. Our results show health centers' central role in family planning, the effects of higher focus and a policy climate more oriented to strong family planning engagement. Results also reveal the challenges health centers face in broadening services, enhancing performance, and promoting privacy and confidentiality.

Learning Areas:
Provision of health care to the public

Learning Objectives:
Understand health center capacity and challenges in providing family planning services. Identify key factors that contribute to broader scope of service and greater privacy for adolescents. Recognize gaps and opportunities for expanding and enhancing access to family planning services.

Keywords: Access, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Susan Wood is an Associate Professor in the Department of Health Policy and Executive Director of the Jacobs Institute of Women's Health at the George Washington University School of Public Health and Health Services. A long–time champion of women's health, Dr. Wood is a PI or Co-PI on several federal and non-federal projects focusing on the intersection of women's health, public health research and data, and policy-making.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4060.0: Focus on community health centers: strategies for increasing access to family planning services