Family Planning Perspectives
Volume 33, Number 1, January/February 2001



TABLES: Public or Private Providers? U.S. Women's Use Of Reproductive Health Services



Table 1. Number of U.S. women aged 15-44 and percentage of these women who obtained family planning services in the preceding year; and number of women aged 15-44 who obtained family planning services in the preceding year and percentage of these women reporting any visit to a nonprivate provider; all by selected characteristics, according to survey year
Characteristic 1982 1988 1995
WOMEN AGED 15-44
No. (in 000s) 54,099 57,900 59,958
% obtaining family planning services 36.5 34.5 36.6*
Age
15-19 31.6 30.4 28.2
20-24 56.2 59.0 60.4
25-29 55.7 53.0 57.7*
30-34 33.9 34.9 42.7**
35-39 19.4 17.0 21.8**
40-44 7.0 6.0 12.0**
Poverty status
<150% of poverty 40.0 36.2 36.5
>=150% of poverty 35.3 34.0 36.6**
WOMEN AGED 15-44 OBTAINING FAMILY PLANNING SERVICES
No. (in 000s) 19,762 19,991 21,926
% who reported any visit to a nonprivate provider† 31.1 35.5* 35.9
Age
15-19 51.0 62.2* 57.8
20-24 36.3 42.2 44.8
25-29 26.7 29.4 32.4
>=30 18.6 22.5 25.8
Poverty status
<150% of poverty 48.0 60.2** 57.5
>=150% of poverty 24.5 27.4 29.6
*Difference with preceding year is statistically significant at p<.05. **Difference with preceding year is statistically significant at p<.01. †In 1982 and 1988, the most recent source of care reported for nearly all recipients of family planning services was classified as either a "clinic" or a "private medical service." (Tiny proportions--1.3% in 1982 and 0.4% in 1988--reported a "counselor" as a source of care.) The percentages reported here for nonprivate providers in 1982 and 1988 are those reported as "clinics." In 1995, "clinics," "hospitals" and "other" providers all were classifed as nonprivate sources, and a source was determined for each different family planning service received. Therefore, for the few women who mentioned multiple sources, we do not know which source was the most recent. To enhance comparability with earlier years, for 1995 we classify women as having used a nonprivate provider if they reported any clinic, hospital or other provider for any family planning service received. Source: For 1982 and 1988: reference 7, Tables 1 and 3.

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Table 2. Percentage of women who reported receiving contraceptive or other reproductive health care services in the past year, by type of care, and percentage of women obtaining each service who went to a publicly funded family planning clinic, all according to specific service received, 1995
Service % obtaining service Among all women obtaining service, % who went to a publicly funded family planning clinic†
All women aged 15-44 Women obtaining care
  Any care Contraceptive services Noncontraceptive services only
No. (in 000s)/total % 59,958 44,082 21,428 22,654 16.9
Contraceptive services‡ 35.7 48.6 100.0 0.0 23.8
Counseling about birth control 14.5 19.7 40.6 0.0 31.2
Check-up for birth control 22.3 30.3 62.4 0.0 23.3
Birth control method/prescription 27.5 37.4 76.9 0.0 23.2
Counseling about sterilization 3.4 4.6 9.4 0.0 18.8
Sterilization operation 1.9 2.6 5.4 0.0 2.0
Preventive gynecologic care 64.9 88.3 88.1 84.5 15.1
Pap test 62.0 84.3 84.9 83.7 14.7
Pelvic examination 61.4 83.5 83.0 84.0 14.4
Pregnancy-related care 19.6 26.7 32.3 21.4 22.5
Pregnancy test 16.0 21.8 25.2 18.6 23.4
Prenatal care 9.5 12.9 14.7 11.3 14.3
Postpregnancy care 5.9 8.0 11.6 4.6 12.0
STD care 33.3 45.3 44.9 45.6 20.0
Test/treatment for gynecologic infection 21.0 28.6 28.9 28.3 14.5
Test/treatment for STD 7.6 10.3 12.9 7.9 31.2
Test for HIV/AIDs 17.3 23.6 23.7 23.4 25.0
†Includes those who reported obtaining the specific service from either a Title X-funded or some other publicly funded family planning clinic; does not include those who reported visiting hospitals, school or military facilities, or other nonspecified types of providers. ‡Includes 1.635 million women who did not report receiving any of the five specific contraceptive services, but who report currently using a reversible method that they obtained from a medical source. Note: Column percentages do not sum to 100% or to subtotals because many women received multiple services.

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Table 3. Number and percentage of women reporting having received contraceptive or other reproductive health care services, by service received, and percentage distribution of women by combination of services received, all according to primary source of reproductive health care in past 12 months
Service All aged 15-44 All getting care Primary source of reproductive healthcare†
Family planning clinic Other Private doctor/HMO
Total Title X Non-Title X
Total no. of women (in 000s) 59,958 44,082 7,398 4,206 3,192 2,714 33,906
PERCENTAGE REPORTING RECEIPT OF SERVICE
Any contraceptive services† 35.7 48.6 68.9 75.0 60.9 47.6 44.2
Preventive gynecologic care§ 64.9 88.3 83.3 86.5 79.2 63.9 91.5
Any pregnancy-related care†† 19.6 26.7 34.6 35.9 33.0 31.3 24.7
Any STD care‡‡ 33.3 45.3 55.7 56.5 54.5 60.4 41.9
PERCENTAGE DISTRIBUTION BY COMBINATION OF SERVICES RECEIVED
Contraceptive services 35.7 48.5 68.9 75.0 60.9 47.6 44.2
Contraceptive services only 2.8 3.8 6.4 5.1 8.0 7.4 2.8
Contraceptive plus preventive gynecologic care 12.4 16.9 18.4 20.7 15.3 11.4 17.0
Contraceptive plus pregnancy care§§ 4.5 6.1 7.0 7.7 6.2 7.1 5.8
Contraceptive plus STD care§§ 9.0 12.2 19.7 22.9 15.6 11.7 10.6
Contraceptive plus pregnancy and STD care§§ 7.1 9.6 17.4 18.7 15.7 10.0 7.9
No contraceptive services 37.8 51.5 31.1 25.0 39.1 52.4 55.8
Preventive gynecologic care only 17.1 23.3 8.4 6.3 11.2 8.2 27.8
Pregnancy care§§ 3.4 4.7 4.2 3.7 4.8 5.6 4.7
STD care§§ 12.6 17.1 12.5 9.2 16.8 30.1 17.2
Pregnancy and STD care§§ 4.6 6.3 6.0 5.8 6.3 8.6 6.2
No services 26.5 0.0 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0
†For women with more than one source type, we assigned one type coded hierarchically: contraceptive service source first (Title X clinic, other clinic, private doctor, and hospital/other), source of preventive gynecologic care second (according to same order) and source of pregnancy care or STD care third (if that was all they received). †Contraceptive services=receipt of one or more of five services in the past 12 months--sterilizing operation; birth control method; check-up or medical test for birth control; counseling about birth control; or counseling about getting sterilized--or is a current user of a reversible method who reported a medical source for her current method. §Preventive gynecologic care=receipt of a Pap test or pelvic exam. ††Pregnancy care=received a pregnancy test, prenatal care, postpartum care or an abortion in the past 12 months. ‡‡STD care=received an STD test/treatment, an HIV test, or a test or treatment for vaginal, urinary tract or pelvic infection in the past 12 months. §§With or without preventive gynecologic care. Note: Numbers of women by primary source of reproductive health care do not sum to totals because data are missing on this variable for some women.

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Table 4. Percentage distribution of women aged 15-44 who reported having received contraceptive or other reproductive health care in the preceding 12 months, by selected characteristics, according to primary source of reproductive health care, and odds ratios from logistic regression analysis of whether women obtain care from a family planning clinic, 1995
Characteristic Total Primary source of reproductive health care Odds ratio
Family planning clinic Other Private doctor/HMO
Total Title X Non-Title X
No. of women obtaining any care (in 000s) 44,018 7,398 4,206 3,192 2,714 33,906 na
Age-group
15-19 9.6 20.0 23.2 15.9 14.6 7.0 2.63***
20-24 17.0 28.8 30.9 26.1 22.1 13.9 2.24***
25-29 18.4 19.4 19.9 18.8 16.5 18.3 1.57**
30-34 20.3 13.9 12.3 16.0 16.7 21.9 1.14
35-39 18.7 10.7 8.8 13.3 15.5 20.8 1.12
40-44 16.0 7.1 5.1 9.8 14.6 18.1 1.00
Marital status
Currently married 53.1 30.6 30.0 31.3 43.0 58.8 1.00
Formerly married 13.8 15.4 13.8 17.5 13.1 13.5 1.45***
Never-married 33.2 54.0 56.2 51.2 43.9 27.7 1.67***
Race/ethnicity
Non-Hispanic white 70.4 53.4 57.4 42.0 56.0 75.2 1.00
Non-Hispanic black 14.9 23.5 23.9 22.9 21.2 12.5 1.85***
Hispanic 10.9 19.8 15.4 25.6 14.4 8.7 1.38***
Other 3.8 3.3 3.4 3.3 8.5 3.6 1.07
Education
<high school 15.7 30.7 31.1 30.1 24.2 11.8 1.41**
Completed high school 36.0 37.1 39.6 33.8 33.2 36.0 1.19*
>=some college 48.2 32.2 29.3 36.0 42.6 52.2 1.00
Eligibility for subsidized care†
Full subsidy 21.0 45.0 45.3 44.5 31.1 15.0 1.84***
Partial subsidy 24.6 29.0 29.2 28.8 32.2 23.1 1.55***
No subsidy 54.4 26.0 25.5 26.7 36.7 61.9 1.00
Insurance type
Private 71.5 39.5 39.9 39.1 49.4 80.2 1.00
Medicaid 16.9 38.2 36.9 39.9 22.4 11.8 3.57***
None 10.1 21.4 22.2 20.5 16.8 7.1 3.01***
Military/other 1.5 0.8 1.0 0.6 11.4 0.9 0.75
Risk status for unintended pregancy
At risk 51.9 65.6 70.7 58.8 46.8 49.3 1.00
Sterilized 23.6 13.6 11.4 16.6 27.3 25.5 0.54***
Not at risk 24.5 20.8 17.8 24.6 25.9 25.2 0.54***
Payment type
Insurance 54.5 15.8 13.4 18.9 37.1 64.1 na
Own income only 24.1 17.0 16.1 18.2 23.3 25.7 na
Medicaid 12.6 31.0 29.2 33.3 18.3 8.3 na
Public/free/sliding-scale 7.2 34.7 39.7 28.2 8.2 1.2 na
Military/school 1.6 1.5 1.6 1.4 13.2 0.7 na
Total 100.0 100.0 100.0 100.0 100.0 100.0 na
*Statistically significant at p<=.05. **Statistically significant at p<=.01. ***Statistically significant at p<=.001. †For the logistic regression, the three poverty-status categories used were <100% of poverty, 100-249% of poverty and >=250% of poverty. Note: na=not applicable.

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Table 5. Odds ratios from logistic regression analyses assessing effects of selected predictor variables on women's having obtained specific types of contraceptive or other reproductive health care services (unweighted N=8,104)
Predictors Contraceptive Preventive gynecologic services Pregnancy-related care STD-related care
Age-group
15-19 4.79*** 0.71 10.58*** 2.79***
20-24 5.40*** 0.84 9.10*** 2.33***
25-29 4.66*** 0.93 8.18*** 2.13***
30-34 2.72*** 0.86 4.88*** 1.64***
35-39 1.69*** 0.82 2.03*** 1.38***
40-44 (ref) 1.00 1.00 1.00 1.00
Marital status
Currently married (ref) 1.00 1.00 1.00 1.00
Formerly married 1.12 0.86 0.44*** 1.49***
Never-married 0.96 0.81* 0.30*** 1.05
Race/ethnicity
Non-Hispanic white (ref) 1.00 1.00 1.00 1.00
Non-Hispanic black 0.84* 1.26* 1.13 1.24**
Hispanic 1.03 0.75** 1.07 1.03
Other 0.54*** 0.78 1.06 0.81
Education
<high school 0.87 0.43*** 1.01 0.83*
Completed high school 0.91 0.77** 1.06 0.86**
>=some college (ref) 1.00 1.00 1.00 1.00
Poverty status
0-99% of poverty 0.90 0.86 1.03 1.02
100-249% of poverty 0.93 0.81* 0.97 1.07
>=250% of poverty (ref) 1.00 1.00 1.00 1.00
Insurance type
Private (ref) 1.00 1.00 1.00 1.00
None 0.78* 0.75* 1.06 1.12
Medicaid 1.21* 1.06 2.98*** 1.72***
Military/other 1.06 1.91* 1.53* 1.20
Risk status for unintended pregnancy
At risk (ref) 1.00 1.00 1.00 1.00
Sterilized 0.11*** 1.32* 0.41*** 1.33***
Not at risk 0.14*** 1.07 1.79*** 1.32***
Primary source of reproductive care
Private doctor/HMO (ref) 1.00 1.00 1.00 1.00
Title X clinic 2.58*** 0.89 1.10 1.31**
Non-Title X clinic 1.66*** 0.51*** 1.08 1.23*
Other provider 1.21 0.18*** 1.28* 1.80***
*Statistically significant at p<=.05. **Statistically significant at p<=.01. ***Statistically significant at p<=.001. Note: ref=reference group.

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© copyright 2001, The Alan Guttmacher Institute.