Abstract
Objectives
While primary care providers are a major source of sexual and reproductive health
(SRH) services in the United States, particularly in rural areas, not all primary
care settings offer a full range of SRH services. We aimed to understand primary care
patient concerns regarding accessing SRH services, including abortion care, outside
of their primary care clinic and if those concerns differed by urban or rural setting.
Study design
An anonymous survey was distributed over a 2-week period between December 2019 to
March 2020 to all adult patients in four primary care clinics in Idaho, Washington,
and Wyoming. The survey assessed patient concerns regarding accessing SRH services
outside of their primary care clinic and their willingness to travel to access SRH
services.
Results
The overall response rate was 69% (745/1086). Over 85% of respondents identified at
least one concern to seeking SRH services outside of a primary care setting, with
cost, insurance coverage, length of wait time, and lack of an established relationship
being the most frequently reported concerns. A majority of respondents were willing
to travel a maximum of 1 hour for most SRH services. Respondents from rural-serving
clinics were significantly more likely to be willing to travel longer amounts of time
for medication abortion, aspiration abortion, and intrauterine device placement.
Conclusion
Our findings highlight that a majority of both urban and rural primary care patients
have concerns regarding accessing SRH services outside of their primary care clinic
and are unwilling to travel more than 1 hour to access most SRH services.
Implications
A majority of primary care patients have concerns regarding accessing SRH services
outside of primary care settings. Health care policy changes should aim to strengthen
the SRH services available in primary care settings to alleviate the burdens primary
care patients face in accessing SRH services outside of their primary care clinic,
particularly for rural populations.
Keywords
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Article info
Publication history
Published online: October 15, 2022
Accepted:
October 5,
2022
Received in revised form:
October 4,
2022
Received:
June 3,
2022
Footnotes
Conflicts of interest: None.
Funding: This study was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR002319, KL2 TR002317, and TL1 TR002318. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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