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.
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LINE CHART: HEDIS Measures of Perinatal Care, by Payer, 2001-05
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LINE CHART: HEDIS Rates of Cervical Cancer and Chlamydia Screening by Payer, 2001-05
>
LINE CHART: HEDIS Rates of Mammograms, by Payer, 2005
>
Vertical Bar CHART: Satisfaction with How Well Doctors Communicated, by Sex and Age, 2005
>
Vertical Bar CHART: Satisfaction with Access to Necessary Care, by Sex and Age, 2005
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