Availability of emergency contraception: A survey of hospital emergency department staff
Availability of emergency contraception: A survey of hospital emergency department staff
复制标题
DOI：
10.1016/j.annemergmed.2005.01.017
复制
发表时间：
2005-08-01
影响因子：
6.2
通讯作者：
Harrison, T
中科院分区：
文献类型：
--
作者：
Harrison, T
研究目的：调查医院急诊科紧急避孕药的可及性，并调查美国天主教和非天主教医院的工作人员。更具体地说，我试图报告一名打电话给医院寻求紧急避孕的妇女获得药物的可能性；(2)如果没有提供紧急避孕措施，医院工作人员是否会提供转介到其他机构；(3)转诊过程的结果。方法：采用“神秘客户”的方法，我打电话给美国所有597家天主教医院和17%的非天主教医院的工作人员（n=615）。我用这种采访方法来反映一个外行妇女打电话询问紧急避孕的可用性的经历。结果：我发现42%的非天主教医院和55%的天主教医院的工作人员说他们不提供紧急避孕措施，即使是在性侵犯的情况下。总体而言，与非天主教医院的工作人员（17%）相比，天主教医院的更多应答者（23%）报告说，他们只向性侵犯受害者提供紧急避孕措施。在那些说他们医院在任何情况下都不提供紧急避孕措施的工作人员中，只有大约一半的人给了来电者有效的转诊，而且大多数转诊无效。结论：为了提高妇女获得紧急避孕药的可及性，医院可以(1)使用药物治疗合作协议，使医院药房能够在没有处方的情况下分发紧急避孕药；(2)制定和沟通支持提供紧急避孕药的书面政策；(3)鼓励遵守宗教或道德准则的卫生保健提供者为寻求紧急避孕药的妇女提供有效的转诊。
Study objective: I investigate accessibility of emergency contraception pills at hospital emergency departments and survey staff at Catholic and non-Catholic hospitals across the United States. More specifically, I sought to report the likelihood that a woman calling a hospital and seeking emergency contraception could access the medication; (2) if emergency contraception is not provided, whether hospital staff would provide a referral to another facility; and (3)the outcome of the referral process.Methods: Using a "mystery client" approach, I telephoned staff at all 597 Catholic hospitals in the United States and at 17% of non-Catholic hospitals (n=615). I used this interviewing method to reflect the experience of a laywoman calling to inquire about the availability of emergency contraception.Results: I found that staff at 42% of non-Catholic hospitals and 55% of Catholic hospitals said that they do not dispense emergency contraception, even in cases of sexual assault. Overall, more respondents at Catholic hospitals (23%) reported that they provide emergency contraception only to victims of sexual assault compared with staff at non-Catholic hospitals (17%). Among staff who said that their hospital does not provide emergency contraception under any circumstances, only about half gave callers a valid referral, and most referrals were ineffective.Conclusion: To improve women's access to emergency contraception, hospitals can (1) use collaborative drug-therapy agreements to enable hospital pharmacies to dispense emergency contraception without a prescription, (2) develop and communicate written policies that support provision of emergency contraception, and (3) encourage health care providers who observe religious or ethical guidelines to provide effective referrals for women seeking emergency contraception.