Integrating Primary Care Services in the Family Planning Clinic: Impact on Reproductive Health Care

Background. In 2013, Maine Family Planning integrated primary care services into their family planning clinic in Belfast, Maine. The clinic expanded its days and hours of service as well. This paper answers the question:  How did integration of primary care affect the provision of specialized family planning services?

Method. A quasi-experimental design compared outcomes from the clinic of interest (Belfast) with those of two matched clinics that were family planning only (Rockland and Waterville). We compared data from electronic medical records from the baseline year (2013) to the first year of the integrated service (2014).

Results. In Belfast, family planning appointments increased by 14%, whereas Rockland and Waterville appointments decreased by 8% and 9%, respectively. Overall, an additional 2% of patients at Belfast reported using some form of contraception, while this number declined by 3% and 4% at Rockland and Waterville. All clinics reported significantly more patients using “most effective methods” (sterilization and LARC). This increase was largest at Belfast, at 66%, and was explained by a steep increase in hormonal implants. Belfast saw significantly more males, and 28% more patients reported use of condoms. Referrals for mammograms and ultrasounds more than doubled in Belfast, although they also increased in the Rockland clinic.

Implications: Integrating additional health services into this family planning clinic allowed the clinic to provide more family planning services and address reproductive health issues of patients who came in for primary care services. Contraceptive use and effectiveness increased, as did the referral volume for reproductive health needs.