Obstetrician-gynecologists as primary care physicians: The Oregon experience—Early perceptions regarding the effects of legislative action

Kirk, Erika; Santa, Jaime Martínez; Heckler, Thomas; Collins, Marcia

doi:10.1016/s0002-9378(98)70326-6

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…[19][20][21] Prenatal care provides a strategic opportunity for infectious disease screening and treatment in these women, who often have little interaction with health care providers. 22,23 If traditional prenatal care fails to address infectious disease screening and treatment, labor and delivery hospitals can perform a crucial role, preventing vertical transmission of infection to infants by screening women with no screening or unknown screening status.…”

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confidence: 99%

Assessment of Screening, Treatment, and Prevention of Perinatal Infections in the Philadelphia Birth Cohort

Jessop¹,

Watson

Mazar

et al. 2005

Am J Med Qual

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Certain population groups are at risk for inadequate prenatal care and transmission of perinatal infections. Philadelphia's birth cohort comprises largely at-risk groups and its infant mortality rate is among the nation's highest. This study identifies factors associated with infectious disease screening, treatment, and prevention in Philadelphia. Delivery charts for a probability sample of 550 patients were reviewed. Demographic factors associated with prenatal and delivery care were identified through Pearson chi-square, analysis of variance, and stepwise logistic regression analysis. Nonstandard and incomplete documentation complicated abstraction. Some prenatal care was noted in 95% of the records and screening varied by disease. Factors independently associated with care include maternal race, insurance status, and maternal age. Screening for infections with well-established recommendations (hepatitis B virus, rubella, syphilis) occurred more often than for group B streptococcus, HIV, hepatitis C virus, and varicella. Adoption of standard reporting forms and processes could improve practice and aid in quality improvement efforts and patient communication.

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confidence: 99%

Assessment of Screening, Treatment, and Prevention of Perinatal Infections in the Philadelphia Birth Cohort

Jessop¹,

Watson

Mazar

et al. 2005

Am J Med Qual

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“…Although the perception that vaccination is not a primary responsibility of obstetricians may be modifiable, 16,17 the primary responsibility for PPV generally falls to the delivery hospital 18 . A survey of hospitals conducted in 1993 in the US found that only 21% of hospitals had policies for rubella PPV 19 .…”

Section: Discussionmentioning

confidence: 99%

“…A recent survey conducted among obstetricians in the US showed that although 85% of the respondents reported that they routinely screen obstetric patients for rubella IgG, almost half of the respondents' practices did not offer rubella PPV. 15 Although the perception that vaccination is not a primary responsibility of obstetricians may be modifiable, 16,17 the primary responsibility for PPV generally Prenatal infection prevention 37 falls to the delivery hospital. 18 A survey of hospitals conducted in 1993 in the US found that only 21% of hospitals had policies for rubella PPV.…”

Section: Discussionmentioning

confidence: 99%

Medical practices for prevention of perinatal infections in Puerto Rico

Dayan¹,

Caquías

García

et al. 2007

Paediatric Perinatal Epid

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Recommendations for screening for maternal infections and interventions to prevent disease in the fetus or newborn have been in place in Puerto Rico for more than 10 years. However, compliance with these recommendations has not been widely documented. We evaluated compliance with rubella/hepatitis B prenatal screening and vaccination recommendations, assessed hospital screening practices for syphilis and HIV, and determined risk factors for suboptimal prenatal care. Records of a random, stratified sample of 2003 pregnant women delivering in eight maternity hospitals in Puerto Rico in 2002 were reviewed. Obstetric prenatal and postnatal records were also reviewed when rubella/hepatitis B surface antigen (HBsAg) screening was not available at the hospital, and to document rubella postpartum vaccination (PPV). Prenatal screening rates were 98.4% for rubella and 98.8% for HBsAg. Overall, 5.4% [95% CI 4.4, 6.5] of women were susceptible to rubella. No eligible women received rubella PPV at the hospital and only 1.5% had documented rubella vaccine prescription at the obstetric records. Only one woman was found to be HBsAg positive and her newborn was adequately treated. However, only 0.9% newborns born to mothers with unknown HBsAg status received hepatitis B vaccine. Screening was documented in 85.7% of the hospital records for HIV and 87.9% for syphilis. Suboptimal prenatal care was more likely among teenagers, low-educated women, and women with >3 previous pregnancies. Screening rates for rubella and hepatitis B were high; however, implementation of recommendations for prevention of rubella and hepatitis B needs to be improved.

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“…Anywhere between 37 to 93% of obstetrician=gynecologists (ob=gyn) consider themselves to be primary care health providers. [6][7][8] The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Care Survey (NHACS) collected information on care provided by office-based physicians and outpatient clinics in a nationally representative sample of healthcare visits and showed that 1 Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan. 2 Division of Gastroenterology, University of California-San Francisco, San Francisco, California.…”

Section: Introductionmentioning

confidence: 99%