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Original Research Article|Articles in Press, 110009

Single-visit insertion of long-acting reversible contraception in a single health system1

Published:March 15, 2023DOI:https://doi.org/10.1016/j.contraception.2023.110009
Single-visit insertion of long-acting reversible contraception in a single health system11None of the authors report conflicts of interest. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Organon, the Society of Family Planning Research Fund or the Clinical and Translational Science Award program of the National Center for Advancing Translational Sciences, National Institutes of Health.
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      ABSTRACT

      Objective

      To identify patient and practice characteristics associated with single-visit placement of long-acting reversible contraception (LARC) across the UNC Health system.

      Study Design

      We conducted a retrospective observational study using existing electronic health records. We abstracted data from charts of individuals ages 15-50 years who received a LARC device between March 15, 2019, and March 14, 2021. Our primary outcome was whether a patient received LARC at one, or after multiple, outpatient visits. We used descriptive statistics to examine patient, clinician, and practice characteristics. We used bivariate analysis and generalized estimating equation (GEE) to examine relationships between characteristics and single-visit LARC receipt.

      Results

      Most of the 4,599 individuals received care at obstetrics and gynecology clinics (3411/4599; 74%), and received their LARC device in a single visit (3163/4599; 69%). The adjusted odds of receiving a LARC in a single visit was highest for those who self-paid (aOR 1.83, 1.19-2.82) and those who received an implant (aOR1.25, 1.07-1.46). Patients seen by advanced practice practitioners (aOR 0.67, 0.56-0.80) or by an internal medicine specialty clinician (aOR 0.13, 0.00-0.35) had lower odds of receiving a single-visit LARC compared to those seen by a specialist obstetrician-gynecologist physician.

      Conclusion

      Most single-visit LARC placements were performed by clinicians in obstetrician-gynecologist specialty practices.

      Implications

      Among individuals seeking long-acting reversible contraceptives from clinics in a single health system in North Carolina, most received a device at a single visit and most single-visit insertions were done by an obstetrician-gynecologist.
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      Article info

      Publication history

      Accepted: March 10, 2023
      Received in revised form: March 5, 2023
      Received: October 27, 2022

      Publication stage

      In Press Accepted Manuscript

      Identification

      DOI: https://doi.org/10.1016/j.contraception.2023.110009

      Copyright

      © 2023 Published by Elsevier Inc.

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