Gynecologists in the VA

Do They Enhance Availability of Sex-specific Services and Policies in the Emergency Department

Datos Bibliográficos

ID9105092
AutoresKenney E Gray (0000-0001-7772-6318, University of Puget Sound, autor de correspondencia), Kristen E Gray, Jodie G Katon (0009-0007-7973-9041, University of Puget Sound, autor de correspondencia), Lisa S Callegari (0000-0003-1303-806X, University of Puget Sound, autor de correspondencia), Kristina M Cordasco (0000-0002-5866-1763, RAND Corporation, autor de correspondencia), Laurie Zephyrin (VA NY Harbor Healthcare System), Laurie C Zephyrin
Año2015
Volumen53
NúmeroSupplement 4Suppl 1
PáginasS76-S80
Fecha de publicación2015-04-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000311
PMID25767980
OpenAlexW2315161504
IdiomaEN
Referencias citadas6

OBJECTIVES: To examine the association between on-site gynecology and availability of sex-specific services and policies in Department of Veterans Affairs (VA) emergency departments (EDs). RESEARCH DESIGN: Cross-sectional analysis using data from a VA national inventory of emergency services for women and gynecologist staffing information from the VA Office of Productivity, Efficiency, and Staffing. SUBJECTS: ED directors from all VA medical centers (N=120). MEASURES: We used logistic regression to evaluate the association between on-site gynecologist full-time equivalents (FTEs, <0.5 and ≥0.5), and availability of sex-specific ED services, such as consult and follow-up within VA by a gynecologist, emergency contraception, rho (D) immunoglobulin, pelvic ultrasound, and transfer policies for obstetric and gynecologic emergencies. All analyses were adjusted for number of ED encounters by women. RESULTS: Greater gynecologist FTE (≥0.5 vs. <0.5) was associated with increased odds of on-site availability of a gynecology consultation in the ED [odds ratio (OR)=10.9; 95% confidence interval (CI): 3.2, 36.6] and gynecologist follow-up within VA after an ED encounter (OR=2.5; 95% CI: 1.0, 6.2). A positive trend was seen in availability of rho (D) immunoglobulin (OR=1.4; 95% CI: 0.6, 3.5) and presence of transfer policies for obstetric (OR=1.7; 95% CI: 0.7, 4.5) and gynecologic emergencies (OR=1.6; 95% CI: 0.6, 4.2). Half of the facilities with <0.5 FTE did not have transfer policies in place or under development. CONCLUSIONS: On-site gynecologist FTE is associated with improved availability of sex-specific care in EDs. Development of transfer processes for obstetric and gynecologic emergencies in settings with limited on-site gynecology is needed

Confidence interval · Emergency department · Family medicine · Gynecology · Logistic regression · Odds · Odds ratio · Staffing · Emergency and Acute Care Studies · Maternal and fetal healthcare · Medicine · Nursing · Reproductive Health and Contraception · Internal Medicine