Confronting segregation of care in OBGYN: a national survey of program directors
Background The structure of ambulatory care in teaching hospitals may contribute to disparities in reproductive outcomes, particularly when outpatient care is segregated by insurance status and race.Objective To investigate the prevalence and characteristics of separate faculty and resident practice...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Health Equity |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/29944694.2025.2530970 |
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| author | Karampreet Kaur Annie Apple Rebecca Hamm Allison Schachter Catherine Salva Sarita Sonalkar Kavita Vinekar Shyann Hall Abike James Arina Chesnokova |
| author_facet | Karampreet Kaur Annie Apple Rebecca Hamm Allison Schachter Catherine Salva Sarita Sonalkar Kavita Vinekar Shyann Hall Abike James Arina Chesnokova |
| author_sort | Karampreet Kaur |
| collection | DOAJ |
| description | Background The structure of ambulatory care in teaching hospitals may contribute to disparities in reproductive outcomes, particularly when outpatient care is segregated by insurance status and race.Objective To investigate the prevalence and characteristics of separate faculty and resident practices in obstetrics and gynecology (OBGYN), including payor and racial segregation.Methods Electronic survey administered to OBGYN Residency Program Directors (PDs) from March to September 2023.Results Ninety-two of 299 PDs responded (31%). Sixty-one programs (66%) reported separate resident and attending practices. Patient assignment was based on appointment availability (77%), patient request (54%), and insurance (37%). Only 30% of programs with separate practices collected data comparing patient demographics, care quality, or outcomes between practices; among these, 72% reported at least one demographic disparity, including differences in race (28%), insurance (67%), and socioeconomic status (61%). A majority reported similar quality of care and patient outcomes between practices, and 64% reported no efforts to integrate.Conclusions Separate attending and resident ambulatory practices in OBGYN are prevalent and can result in segregated care. National guidance is needed to promote equitable outpatient care while ensuring strong educational experiences. Solutions must be data-driven, locally-tailored, and developed in collaboration with patients, clinicians, educators, and professional organizations. |
| format | Article |
| id | doaj-art-b2c124f35af64668aa1e917db5352e59 |
| institution | Kabale University |
| issn | 2994-4694 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Health Equity |
| spelling | doaj-art-b2c124f35af64668aa1e917db5352e592025-08-26T08:38:01ZengTaylor & Francis GroupJournal of Health Equity2994-46942025-12-012110.1080/29944694.2025.2530970Confronting segregation of care in OBGYN: a national survey of program directorsKarampreet Kaur0Annie Apple1Rebecca Hamm2Allison Schachter3Catherine Salva4Sarita Sonalkar5Kavita Vinekar6Shyann Hall7Abike James8Arina Chesnokova9Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAPenn Center for Mental Health, Perelman School of Medicine, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USAUniversity of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USAObstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USAPerelman School of Medicine, Philadelphia, Pennsylvania, USABackground The structure of ambulatory care in teaching hospitals may contribute to disparities in reproductive outcomes, particularly when outpatient care is segregated by insurance status and race.Objective To investigate the prevalence and characteristics of separate faculty and resident practices in obstetrics and gynecology (OBGYN), including payor and racial segregation.Methods Electronic survey administered to OBGYN Residency Program Directors (PDs) from March to September 2023.Results Ninety-two of 299 PDs responded (31%). Sixty-one programs (66%) reported separate resident and attending practices. Patient assignment was based on appointment availability (77%), patient request (54%), and insurance (37%). Only 30% of programs with separate practices collected data comparing patient demographics, care quality, or outcomes between practices; among these, 72% reported at least one demographic disparity, including differences in race (28%), insurance (67%), and socioeconomic status (61%). A majority reported similar quality of care and patient outcomes between practices, and 64% reported no efforts to integrate.Conclusions Separate attending and resident ambulatory practices in OBGYN are prevalent and can result in segregated care. National guidance is needed to promote equitable outpatient care while ensuring strong educational experiences. Solutions must be data-driven, locally-tailored, and developed in collaboration with patients, clinicians, educators, and professional organizations.https://www.tandfonline.com/doi/10.1080/29944694.2025.2530970Health disparitieshealth equitysegregation of careambulatoryobstetrics and gynecology |
| spellingShingle | Karampreet Kaur Annie Apple Rebecca Hamm Allison Schachter Catherine Salva Sarita Sonalkar Kavita Vinekar Shyann Hall Abike James Arina Chesnokova Confronting segregation of care in OBGYN: a national survey of program directors Journal of Health Equity Health disparities health equity segregation of care ambulatory obstetrics and gynecology |
| title | Confronting segregation of care in OBGYN: a national survey of program directors |
| title_full | Confronting segregation of care in OBGYN: a national survey of program directors |
| title_fullStr | Confronting segregation of care in OBGYN: a national survey of program directors |
| title_full_unstemmed | Confronting segregation of care in OBGYN: a national survey of program directors |
| title_short | Confronting segregation of care in OBGYN: a national survey of program directors |
| title_sort | confronting segregation of care in obgyn a national survey of program directors |
| topic | Health disparities health equity segregation of care ambulatory obstetrics and gynecology |
| url | https://www.tandfonline.com/doi/10.1080/29944694.2025.2530970 |
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