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Willing but unable: Physicians' referral knowledge as barriers to abortion care.

ABSTRACT: Abortion care is a crucial part of reproductive healthcare. Nevertheless, its availability is constrained by numerous forces, including care referrals within the larger healthcare system. Using a unique study of physician faculty across multiple specialties, we examine the factors associated with doctors' ability to refer patients for abortion care among those who were willing to consult in the care of a patient seeking an abortion (N = 674). Even though they were willing to refer a patient for an abortion, half (53%) of the physicians did not know how and whom to make those referrals, though they care for patients who may need them. Those with the least referral knowledge had not been taught abortion care during their medical training and were in earlier stages of their career than those who had more knowledge. This research exposes another obstacle for those seeking an abortion, a barrier that would be overcome with a clear and robust referral system within and across medical specialties.

SUBMITTER: Anderson EM

PROVIDER: S-EPMC8693343 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Willing but unable: Physicians' referral knowledge as barriers to abortion care.

Anderson Elizabeth M EM Cowan Sarah K SK Higgins Jenny A JA Schmuhl Nicholas B NB Wautlet Cynthie K CK

SSM - population health 20211214

Abortion care is a crucial part of reproductive healthcare. Nevertheless, its availability is constrained by numerous forces, including care referrals within the larger healthcare system. Using a unique study of physician faculty across multiple specialties, we examine the factors associated with doctors' ability to refer patients for abortion care among those who were willing to consult in the care of a patient seeking an abortion (<i>N</i> = 674). Even though they were willing to refer a patie ...[more]

PMID: 34984221

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Project description:BackgroundObesity prevalence is increasing globally. Bariatric surgery is an effective treatment for severe and complex obesity resulting in significant and sustained weight loss. In Sweden, most bariatric surgery patients are referred by primary care physicians. We aimed to explore barriers for physicians to refer patients with severe and complex obesity for bariatric surgery.MethodsA questionnaire survey was in 2019 emailed to 1100 primary care physicians in the Skåne and Kronoberg regions in south Sweden. The survey focused on referral patterns, knowledge and attitudes towards bariatric surgery and concerns about postoperative complications. We created different statistical indices for referral patterns, knowledge, attitudes and concerns about bariatric surgery. To analyze the correlation between these indices, we did Spearman's correlations and regression analyses.ResultsOf 1100 email respondents, we received 157 (14%) completed surveys. Among 157 physician respondents, 73% answered that they had good knowledge about the referral criteria for bariatric surgery, whereas 55 and 60% answered correctly to two items on criteria for bariatric surgery. A majority of respondents (84%) stated that their patients initiated referral to bariatric surgery. Half of the respondents had concerns about postoperative medical and surgical complications, but another half had a positive attitude to bariatric surgery as a treatment for obesity comorbidities. Almost half of the respondents (44%) answered that they needed to learn more about bariatric surgery. We found significant positive correlations between high knowledge and referral patterns (r = 0.292, p < 0.001) and positive attitudes (r = 0.235, p < 0.001) respectively. We found significant reverse correlations between concerns and referral patterns (r = - 0.355, p < 0.001) and between positive attitudes and concerns (r = - 0.294, p < 0.001). In logistic regression high levels of concerns explained low willingness to refer for bariatric surgery (Odds Ratio 0.2, 95% confidence interval 0.1-0.7).ConclusionAccording to this Swedish survey among primary care physicians, high levels of concerns about bariatric surgery among physicians seemed to be a barrier to refer patients with severe and complex obesity for bariatric surgery. Since high knowledge about obesity and bariatric surgery correlated negatively to concerns and positively to favorable attitudes to bariatric surgery, more knowledge about obesity and bariatric surgery is warranted.

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Willing but unable: Physicians' referral knowledge as barriers to abortion care.

Publications

Willing but unable: Physicians' referral knowledge as barriers to abortion care.

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