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PubMedDate not supplied

First family planning visits by young women.

Data from the 1982 National Survey of Family Growth indicate that among sexually active women aged 15-24, friends and parents are the main sources of referral for first family planning visits. Friends are the leading referral source for women who attend clinics, and parents are the leading referral source for those who go to private doctors. Despite the importance of confidentiality to many teenagers, women who make their first family planning visit before the age of 17 are more likely to be referred by their parents than are those whose first visit occurs when they are 17 or older. Race, age at first visit and income influence women's choice of a provider (clinic or private doctor). Black women, low-income women and younger women are considerably more likely than their counterparts to use a clinic at first family planning visit. At their first visit, sixty-seven percent of women receive birth control counseling, and only 50 percent begin using a contraceptive method. Among clinic users, white women are more likely than black women to begin a birth control method (50 percent vs. 40 percent). Women whose first visit takes place before their first conception (including those who have never been pregnant) are much more likely than women whose first visit occurs after their first pregnancy ends to begin a method. Women who make their first visit during their first pregnancy are more likely than those who are not pregnant to receive a pregnancy test or counseling on matters other than birth control.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Characteristics of contraceptive acceptors in Lusaka, Zambia.

This paper reports on a study conducted in Lusaka, Zambia in which 2,912 client records were examined in 22 randomly selected clinics throughout Lusaka Province. The purpose of the study was to assist the government and the local family planning association in targeting future efforts to extend services to underserved populations. Among newly enrolled acceptors in 1984, the study revealed a surprisingly low median age of 24 and a median parity of 3. The majority were married, had some secondary education, were unemployed housewives, and were breastfeeding at the time of the first visit. Nearly half had used contraceptives before. Over three-fourths of the clients received contraceptive pills when they enrolled. They returned to the clinic an average of 2.4 times during the first year, but only 24 percent were still active after 12 months. The availability of recently released census data allowed a comparison of contraceptive acceptors with women in the general Lusaka population. Data from urban clinics and smaller clinics in rural parts of the province revealed few significant rural-urban differences. Finally, the study examined trends in age, parity, and education of contraceptive users over a ten-year period.

Adult↗
PubMedDate not supplied

Family planning clinic services in U.S. counties, 1983.

Organized family planning clinics are a major source of contraceptive services for low-income women, who are less likely than higher income women to be using a contraceptive method. A 1983 study estimated that 9.5 million U.S. women with family incomes below 150 percent of poverty were at risk of unintended pregnancy, and identified a network of 5,106 clinics providing them with services. Seventy-six percent of all counties in the United States have organized clinics that offer family planning services; almost all of those without services are nonmetropolitan counties. An estimated 52 percent of low-income women at risk of unintended pregnancy were served by organized family planning clinics in 1983, while the rest either went unserved or sought care elsewhere. Ten percent of low-income women not served by clinics live in counties that have no family planning clinics, but 67 percent live in counties where existing clinics reach fewer than half of potential low-income patients. More sites may be needed, particularly in counties without clinics, to effectively serve low-income women at risk of unintended pregnancy. However, since the majority of unserved women live in counties where at least one clinic exists, coverage might be improved through increased accessibility and outreach.

Community Health Centers↗
PubMedDate not supplied

Legal abortion in Italy: 1980-1981.

In 1980 and 1981, there were 446,430 legal abortions performed in Italy. There were about 345 legal abortions per 1,000 live births in 1980 and 363 in 1981. About 1.6 percent of women aged 15-49 obtained abortions in both years. An analysis of the characteristics of Italian women who obtained abortions indicates that most were married (about 70 percent), aged 18-36 (74 percent), had had less than a high school education (74 percent) and had had at least one previous live birth (70-75 percent). In 1981, 88 percent of abortions were obtained in public hospitals; 58 percent were carried out at eight or fewer weeks of gestation; and 78 percent were performed under general anesthesia. Only 20 percent were performed without an overnight stay in the hospital; and over 40 percent of women were hospitalized for two days or longer. Infection after the abortion was reported in only 0.03 percent of cases in 1981, and hemorrhage was reported in only 0.27 percent. In 1981, between 43 percent and 84 percent of gynecologists (depending on the region of the country) declined to perform abortions on grounds of conscience.

Abortion, Legal↗
PubMed1985

Estimating patient-level nursing home costs.

This article presents a methodology developed to estimate patient-level nursing home costs. Such estimates are difficult to obtain because most cost data for nursing homes are available from Medicare or Medicaid cost reports, which provide only average values per patient-day across all patients (or all of a particular payer's patients). The methodology presented in this article yields "resource consumption" (RC) measures of the variable cost of nursing staff care incurred in treating individual nursing home patients. Results from the application of the methodology are presented, using data collected in 1980 on a sample of 961 nursing home patients in 74 Colorado nursing homes. This type of approach could be used to link nursing home payments to the care needs of individual patients, thus improving the overall equity of the payment system and possibly reducing the access barriers facing especially Medicaid patients with high-cost care needs.

Colorado↗
PubMedDate not supplied

Family planning clinic services in the United States, 1983.

Almost five million women were enrolled in family planning clinics in the United States in 1983, eight percent more than in 1981. The number of family planning provider agencies declined slightly, from 2,504 to 2,462, but the number of clinic sites that could be identified increased slightly, from 5,124 to 5,174. Family planning clinics operate in three-quarters of U.S. counties; in 1975, the last time county coverage was checked, four-fifths of the counties had clinics. About one in 20 women who are exposed to the risk of unintended pregnancy and live in unserved counties are teenagers or low-income women. Nonmetropolitan counties are more likely to be without clinics than are metropolitan counties. Overall, there are 417,000 low-income women and 249,000 teenagers at risk of unintended pregnancy living in counties where there are no family planning clinics. In 1983, health departments constituted six in 10 of all family planning agencies and served two-fifths of all family planning clinic patients; Planned Parenthood affiliates accounted for fewer than one in 10 agencies and served more than one-quarter of all patients. Hospitals and all other agencies served about one-third of the total 1983 caseload. These patterns were similar to those reported for 1981. Family planning clinics continue to serve primarily low-income women: Four-fifths of the nearly five million clinic patients in 1983 had family incomes below 150 percent of the federally defined poverty level. About 1.6 million women aged 19 and younger were served, representing one-third of all clinic patients in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Characteristics of vasectomies performed in selected outpatient facilities in the United States, 1980.

In 1981 the American Association of Gynecologic Laparoscopists and the Division of Reproductive Health, Centers for Disease Control, jointly conducted a study of vasectomies performed in outpatient facilities in 1980 in the United States. One hundred twenty-nine facilities that responded to either a mailed questionnaire or a telephone interview stated that vasectomies were performed there in 1980. The average cost was $273, with a range of $50-1,000. Facilities differed markedly in the use of anesthesia. Freestanding surgical centers reported the use of general anesthesia for 29% of the vasectomies. Other types of facilities were more likely to use local or regional anesthesia. Our data suggest areas for further research to improve the availability and safety of vasectomy.

Anesthesia, General↗