Journal of women's health
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Journal of women's health · Jan 2022
Barriers and Challenges to Making Referrals for Treatment and Services for Opioid Misuse in Family Planning Settings.
Background: In this opioid overdose epidemic, women are an overlooked group seeing increasing rates of overdose death. Implementation challenges have prevented evidence-based interventions from effectively reaching women who misuse opioids, with gaps in access to effective treatment and services. Family planning clinics could serve as important points of contact for referral to needed treatments and services. ⋯ Controlling for other factors, race/ethnicity, urbanicity, workplace role, and substance use training were associated with differences in acceptability. Conclusions: Family planning settings could play a critical role in connecting women who misuse opioids to treatment and services. Strategies are needed to increase the acceptability of evidence-based interventions and the feasibility of having family planning staff play a linkage role.
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Journal of women's health · Jan 2022
Improving Access to and Quality of Sexual and Reproductive Health Services for Adolescents in the United States.
Equitable access to high quality adolescent sexual and reproductive health (ASRH) services can help reduce unintended pregnancies, sexually transmitted diseases, and disparities in these outcomes. The Centers for Disease Control and Prevention (CDC), Division of Reproductive Health, has a long history of working to improve access to and quality of ASRH services through applied research and public health practice. ⋯ We conclude by discussing future directions. In disseminating key strategies and resources from this work, we aim to support broader public health and clinical efforts to strengthen ASRH care in the United States in ways that promote health equity.
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Journal of women's health · Jan 2022
Incidence of Severe Maternal Morbidity During Delivery Hospitalization in U.S. Commercially Insured and Medicaid Populations.
Objective: To estimate the incidence rate and associated risk factors of severe maternal morbidity (SMM) in commercially and Medicaid-insured women. Materials and Methods: This was a retrospective cohort study of women with a live inpatient delivery recorded in 2016 in the MarketScan® databases for commercially insured and Medicaid populations. The incidence of SMM, defined by the Center for Disease Control and Prevention's algorithm of International Classification of Diseases, 10th edition diagnostic and procedural codes, was determined. ⋯ A multifetal gestation was also associated with SMM in both Commercial (OR 3.37; 95% CI 2.80-4.10) and Medicaid populations (OR 2.26; 95% CI 1.86-2.75). Conclusion: SMM occurred in 1.1% of live inpatient deliveries. A cesarean delivery, multifetal gestation, race, region, and several pre-existing comorbidities and obstetric complications were associated with SMM.
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Journal of women's health · Jan 2022
Sex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization.
Background: The Veterans Affairs (VA)-developed Care Assessment Need (CAN) score, a risk-stratification tool used to identify complex high-risk patients and guide VA care coordination, was designed to predict hospitalization or death. Little is known about its utility in predicting primary care utilization or if gender differences in this metric are detectable. Our objective was to determine association of CAN score quintiles with high primary care visit (PCV) utilization among Veterans, the impact of adding reproductive health and psychosocial variables to the model and the difference between men and women Veterans. ⋯ However, there was a significant interaction between sex and CAN quintiles (p < 0.001). After adjusting for all the covariates, CAN score quintiles appeared to have stronger associations and better predictive accuracy on the risk of 1-year heavy PCV utilization for men than for women. Conclusion: Further research is needed to understand sex differences in Veterans Health Administration clinical complexity measures and whether they can be successfully used to identify high-risk, high-utilizing women Veterans.