Women's Health USA 2007

Health Services Utilization

Quality of Women's Health Care

Indicators of the quality of health care can provide important information about the effectiveness, safety, timeliness, and patient-centeredness of women’s health services.

Indicators used to monitor women’s health care in managed care plans include the timeliness of prenatal care, receipt of postpartum checkups after delivery, screening for chlamydia, screening for cervical cancer, and receipt of mammograms. In 2005, the rate of perinatal services and chlamydia screening increased, while the rate of cervical cancer screening among women in commercial plans rose after a decrease during 2004.

Perinatal services—prenatal care and postpartum checkups—appear to be more accessible in commercial (private) plans than in public-sector plans financed by Medicaid. The same is true of cervical cancer screening, which is received at least once every 3 years by nearly 82 percent of commercially-insured women and 65 percent of women covered by Medicaid.

Chlamydia screening is the one screening service that is more common among Medicaid-enrolled women than those with private coverage: 52.4 percent of Medicaid-enrolled women aged 21–25 had a chlamydia screen in the previous year, compared to 35.2 percent of commercially-insured women.

In 2005, the rate of mammograms for women aged 52–69 was approximately the same for women with private coverage and those covered through Medicare. However, Medicaid-enrolled women were considerably less likely to receive a mammogram at least once every 2 years.

Patients’ personal experiences of health care also reflect on the quality of care, as those who are not satisfied with their providers may be less likely to continue with treatments and seek further services.¹ Two aspects that may contribute to better outcomes are patients’ perceptions of how well their doctors or other health care providers communicate with them and access to necessary health care services, such as appointments with doctors or specialists, or obtaining necessary tests or treatments. In 2005, women under age 75 were consistently less satisfied than men with their personal experiences of both of these aspects of care.

In 2005, fewer females were satisfied with how well their doctors communicated (81.0 percent), compared to males (84.3 percent). However, this varied across age groups. Younger men and women were least likely to be satisfied, and women were less satisfied than men in every age group, except those 75 and older. Among 18- to 44-year-olds, 77.1 percent of women and 80.4 percent of men were satisfied, while 88.0 percent of women and 87.6 percent of men aged 75 and older reported satisfaction with how well doctors communicate. Non-Hispanic White women (83.0 percent) were also more likely than non-Hispanic Black or Hispanic women (76.8 and 76.7 percent, respectively) to be satisfied (data not shown).

In 2005, men were more likely than women (67.0 versus 62.5 percent) to be satisfied with their ability to get necessary care from physicians or specialists—including obtaining treatments or tests—though women aged 75 and older were more likely than their male counterparts (76.9 versus 74.8 percent) to be satisfied. Older men and women were also more likely than their younger counterparts to be satisfied with their access to necessary care. Among females, 60.0 percent of 18- to 44-year-olds were satisfied compared to 72.8 percent of those aged 65–74 and nearly 77 percent of those aged 75 and older.

¹Fan VS, Burman M, McDonnell MB, Fihn SD. Continuity of Care and Other Determinants of Patient Satisfaction with Primary Care. Journal of General Internal Medicine. 2005; 20:226-233.

Women's Health USA 2007 is not copyrighted. Readers are free to duplicate and use all or part of the information contained on this page. Suggested Citation: U.S. Department of Health and Human Services, Health Resources and Services Administration, Women's Health USA 2007. Rockville, Maryland: U.S. Department of Health and Human Services, 2007.