A comparison of the preventive health care provided by women's health centers and general internal medicine practices

OBJECTIVE: To evaluate women's health centers as alternatives to traditiona l internal medicine practices. DESIGN: Cross-sectional mailed survey. SETTING: A women's health center and an internal medicine practice at each of three university-affiliated teaching hospitals. PATIENTS:There were 3,035 female patients randomly selected to receive a ma iled survey after their office visits. MEASUREMENTS AND MAIN RESULTS: The survey asked for patient characteristics , patient satisfaction, and rates of gender-specific preventive health serv ices. The survey response rate was 64% (1,942/3,035). Patients at women's h ealth centers were younger, more educated, had higher physical functioning but lower mental health functioning, and more of them were single and emplo yed. Patient satisfaction was similar at the two types of practices, althou gh patients at women's health centers were more satisfied with certain aspe cts of the patient-provider interaction. After adjusting for measured diffe rences in patient characteristics and site, patients at women's health cent ers were more likely to receive discussions on hormone replacement therapy (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1, 2.2) and dietary ca lcium (OR 1.3; 95% CI 1.1, 1.6). They were also more likely to receive thei r gender-specific preventive health services from their primary care provid er: breast examination (OR 2.0; 95% CI 1.5, 2.6), Pap smear (OR 2.4; 95% CI 1.9, 3.1), hormone replacement therapy discussion (OR 2.2; 95% CI 1.5, 3.3 ), and dietary calcium discussion (OR 2.6; 95% CI 1.7, 3.9). These findings remained when the analyses were limited to patients of female providers on ly. CONCLUSIONS:In this study, patients at women's health centers were more lik ely to receive gender-specific health prevention counseling than patients a t internal medicine practices. Moreover, patients were more likely to recei ve their gender-specific preventive health services from their primary care providers.