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At least 127 records · Page 7Linked to original sources
PubMed1995

Standards of care in reproductive health services.

Standards of care for all medical services are designed by and for professionals and generally follow medical professional society guidelines. Most managed care organizations rely on professional medical standards of practice, which provide broad guidelines to providers. Family planning agencies, on the other hand, generally follow Title X program guidelines, which provide specific standards of care. The Title X guidelines include detailed instructions about service delivery and program content. The differences between these two sets of standards result in a wide variation in practice guidelines across the spectrum of health care providers. From the patient perspective, evaluation of care is generally not related to professional standards, but instead focuses on quality measures related to access and interpersonal aspects of care. The member satisfaction surveys developed by some managed care organizations now have a large enough sample size to provide meaningful measures of patient satisfaction at the individual provider level. A uniform set of practice guidelines is needed for family planning services that incorporates the strengths of all three approaches and that link performance to generally accepted practice guidelines.

Adolescent↗
PubMed2006

Post-abortion care and voluntary HIV counselling and testing--an example of integrating HIV prevention into reproductive health services.

OBJECTIVE: To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion. METHOD: 706 women were provided with post-abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use and determined the HIV status of those who accepted VCT. Using a nested case-control design, we compared women who accepted HIV testing with women who did not. To study the association between socioeconomic factors, HIV testing acceptance and condom use in more detail, we did stratified analyses based on age and marital status. RESULTS: 58% of the women who had an unsafe abortion accepted HIV testing. Women who earned an income were more likely to accept testing than housewives. Women who accepted testing were more likely to accept using a condom. The HIV prevalence rate was 19% among single women aged 20-24 years and 25% among single women aged 25-45 years. CONCLUSION: HIV testing and condoms were accepted by most women who had an unsafe abortion. The poor reproductive health of these women could be improved by good post-abortion care that includes contraceptive counselling, VCT and condom promotion.

Abortion, Induced↗
PubMed1987

Reproductive Health Services v. Webster, 17 March 1987, amended on 30 April 1987.

The plaintiff physicians and organizations providing abortion-related services challenged the constitutionality of provisions of a Missouri statute that a) state that life begins at conception and that unborn children have a protectable interest in life, health, and well being; b) require a physician to inform a woman seeking an abortion of certain facts; c) require all post sixteen-week abortions to be performed in a hospital; d) require certain tests to be performed in order to determine gestational age and viability; and e) prohibit the use of public funds, public employees, and public facilities for performing or assisting an abortion or encouraging or counseling an abortion except to save a woman's life. The Court ruled that all of these provisions were unconstitutional and in conflict with its previous rulings on a woman's right to obtain an abortion. In a related case the United States District Court, E.D. Missouri, E.D., held that the plaintiff physicians could not attack a statement of intent of the same law, which provides that "It is the intention of the general assembly of the state of Missouri to grant the right to life to all humans, born and unborn, and to regulate abortion to the full extent permitted by the Constitution of the United States, decisions of the United States Supreme Court, and federal statutes." See Women's Health Ctr. of West Cty. v. Webster, 24 September 1987, 670 F.Supp. 845.

Abortion, Induced↗
PubMed1987

Men's reproductive health services in family planning settings: a pilot study.

A 1984 pilot survey of administrators of 35 agencies offering family planning services revealed that all offered counseling/educational services for males, and 89 per cent offered medical/supply services for males. Nevertheless, total utilization of these services is low. Major barriers related to the provision of services to male clients are resource limitations, inadequate training, and negative or ambivalent staff attitudes; these factors may contribute to the discrepancy between service offering and utilization.

Contraceptive Devices, Male↗
PubMed1995

Promising approaches for adolescent reproductive health service delivery. The role of school-based health centers in a managed care environment.

Within the arena of adolescent health care, the most critical service delivery issue is access to care. Efforts to contain health care expenditures through managed care plans inevitably conflict with efforts to deliver truly comprehensive preventive services to all adolescents. Because of the substantial increase in risk behaviors, prevention efforts require frequent contacts if interventions are to be made before risk behaviors occur or soon after their onset. In addition, yearly screening for all adolescents is likely to identify many teens who could benefit from early interventions. Enabling school-based health centers to provide services in coordination with managed care systems would go far to ensure access to care, as well as appropriate attention to the special needs of adolescents, in a timely and cost-effective way. Furthermore, that access would not be tied solely to the family's choice of provider or to the provider mandated by the adolescent's insurance plan. Underlying any approach to coordination of services, however, is the need for managed care providers to understand and affirm a preventive care investment in young people as a means of reducing health care expenditures, an investment that would pay dividends not only during the adolescent years but into adulthood as well. Whether the willingness exists to make this investment, when the cost savings may not directly accrue to the adolescent's current HMO, presents a conflict between the present interests of the HMO and the future interests of whatever provider the adolescent sees as an adult. As managed care systems are more widely adopted, it will be important to ensure that they adequately incorporate the service delivery components that have been found to be efficacious in serving adolescents. Given the leading role school-based health centers can play in providing preventive health care and health promotion, managed care providers should be encouraged to develop strong partnerships with such centers, so that the dual goals of high-quality care and cost containment can be achieved.

Adolescent↗