Standards of care in reproductive health services.

ABSTRACT

PIP: There are three standards of care generally being applied to medical professionals in the US. First, there are standards of care for all medical services designed by and for professionals, which generally follow medical professional society guidelines. Most managed care organizations rely upon these professional medical standards of practice, which provide broad guidelines to providers. Family planning agencies, however, tend to follow Title X program guidelines providing specific standards of care. These latter guidelines include detailed instructions about service delivery and program content. Differences between these two sets of standards result in a wide variation in practice guidelines across the spectrum of health care providers. The third standard of care derives from the patient's perspective. Patients tend to evaluate care not with regard to professional standards, but instead to access and the interpersonal aspects of care. Member satisfaction surveys developed by some managed care organizations now have a large enough sample size to provide meaningful measures of patient satisfaction at the individual provider level. A uniform set of practice guidelines is therefore needed for family planning services which incorporates the strengths of these three approaches and which links performance to generally accepted practice guidelines.