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The majority of preventative health care visits among women of reproductive age were with obstetrician-gynaecologists (OB-GYNs), according to a University of Massachusetts Amherst study published in .

Preventative health may be more generally associated with primary care, but the research concluded that 61% of wellness visits for women aged 15鈥�49 were with OB-GYNS and even those with chronic health conditions visited an OB-GYN for over 40% of their preventive care appointments.

The study鈥檚 findings also reveal that certain recommended services rarely occurred in any setting. Screening for depression, for example, happened in only 6% of primary care visits and just under 4% of visits with OB-GYNs, despite provisions for preventative health in the .

Health services researcher Laura Attanasio, assistant professor of health policy and management in the University of Massachusetts School of Public Health and Health Sciences and lead author of the study, said, 鈥減reventive care is important for helping people optimise their wellness鈥�.

鈥淭here have been various policy measures over the years to try to increase people鈥檚 use of preventive care, including a provision in the Affordable Care Act, which required that certain preventive services be covered at no cost to patients for that visit or that service.鈥�

Typically, these initiatives are 鈥渁imed at primary care, which doesn鈥檛 necessarily account for the fact that, in fact, reproductive-age women are largely seeing OB-GYNs for preventive care,鈥� she added.

Attanasio and team analysed data from 2011 to 2018 from the of office-based physicians which provided a national sample based on visits rather than on the care individuals received over time.

鈥淲hen we looked at the services that were provided by physician type, we found not surprisingly that OB-GYNs emphasised more reproductive-related services 鈥� things like pap tests, pelvic exams and provision of contraceptive medications,鈥� Attanasio said.

鈥淲hereas in general practitioner visits the non-reproductive-related services were more common 鈥� things like lipid tests, glucose tests for diabetes and a complete blood count.鈥�

Attanasio said 30% of visits with generalist physicians included lipid testing for cholesterol levels, compared to an 鈥渁stonishingly low鈥� 2.8% of visits with OB-GYNs.

鈥淥n the flip side, some reproductive-related services may be underprovided in primary care visits,鈥� she said.

鈥淲e can just see that there are pretty big differences across physician specialty, including for women with chronic conditions.鈥�

Attanasio suggested聽the reason聽for these discrepancies聽could be聽due to preventive care guidelines being聽updated frequently, which聽requires聽changes in clinical practice, plus聽the guidelines may differ across professional organisations. The study鈥檚 findings can inform additional research to determine where reproductive-age women 鈥� and particularly those with chronic conditions 鈥� should optimally receive preventive healthcare services.

The paper concludes, 鈥淥ur results provide baseline information about the frequency of services in preventive visits; given the slow and uneven incorporation of new guidelines into clinical practice, trends in service provision are likely to persist.鈥�

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