Gynecologists in the VA: do they enhance availability of sex-specific services and policies in the emergency department?

Medical Care
Kristen E GrayLaurie Zephyrin

Abstract

To examine the association between on-site gynecology and availability of sex-specific services and policies in Department of Veterans Affairs (VA) emergency departments (EDs). Cross-sectional analysis using data from a VA national inventory of emergency services for women and gynecologist staffing information from the VA Office of Productivity, Efficiency, and Staffing. ED directors from all VA medical centers (N=120). We used logistic regression to evaluate the association between on-site gynecologist full-time equivalents (FTEs, <0.5 and ≥0.5), and availability of sex-specific ED services, such as consult and follow-up within VA by a gynecologist, emergency contraception, rho (D) immunoglobulin, pelvic ultrasound, and transfer policies for obstetric and gynecologic emergencies. All analyses were adjusted for number of ED encounters by women. Greater gynecologist FTE (≥0.5 vs. <0.5) was associated with increased odds of on-site availability of a gynecology consultation in the ED [odds ratio (OR)=10.9; 95% confidence interval (CI): 3.2, 36.6] and gynecologist follow-up within VA after an ED encounter (OR=2.5; 95% CI: 1.0, 6.2). A positive trend was seen in availability of rho (D) immunoglobulin (OR=1.4; 95% CI: 0.6, 3.5) and p...Continue Reading

References

May 7, 2003·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Donna L WashingtonElizabeth M Yano
May 7, 2003·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Elizabeth M YanoCarole Turner
Oct 24, 2006·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Elizabeth M YanoDonna L Washington
Mar 11, 2008·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Michelle D SeeligDonna L Washington
Apr 10, 2014·Journal of General Internal Medicine·Elizabeth M YanoPatricia Hayes

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Citations

Sep 16, 2017·Journal of General Internal Medicine·Elisheva R DananTimothy J Wilt
Mar 7, 2019·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Kristina M CordascoDonna L Washington
Jul 11, 2020·Journal of the American Association of Nurse Practitioners·Debbie T DevineGail Powell-Cope

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