Abstract：
OBJECTIVE: This study examined demographic, practice, and area-level characteristics associated with family physicians\' (FP) provision of maternity care.
METHODS: Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs\' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county-level factors (percentage of reproductive-age women, the number of obstetrician-gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive-age women). We performed summary statistics and multivariate logistic regression analyses.
RESULTS: Of the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1-5.1) and safety-net settings (OR 1.9, 1.7-2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8-2.3) than those in the top quintile, with more OBGYNs and CNMs.
CONCLUSIONS: FPs in high-needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need.
METHODS: Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs\' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county-level factors (percentage of reproductive-age women, the number of obstetrician-gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive-age women). We performed summary statistics and multivariate logistic regression analyses.
RESULTS: Of the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1-5.1) and safety-net settings (OR 1.9, 1.7-2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8-2.3) than those in the top quintile, with more OBGYNs and CNMs.
CONCLUSIONS: FPs in high-needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need.
摘要：
目的：本研究调查了人口学，实践,以及与家庭医生（FP）提供产妇护理相关的地区级特征。
方法：使用美国家庭医学认证委员会的考试申请调查数据，我们调查了FPs\'产妇保健服务提供与(1)人口统计学(性别，多年的实践，种族/种族)，(2)实践特征(大小，所有权,rurality),和(3)县级因素(育龄妇女的百分比，每100,000育龄女性的妇产科医生（OBGYN）和认证护士助产士（CNM）的数量）。我们进行了汇总统计和多变量逻辑回归分析。
结果：在样本中的59,903个FP中，7.5%提供产妇护理。在农村执业的FPs提供产妇护理的可能性是在城市地区执业的FPs的2.5倍。学术上的FPs（比值比[OR]4.6，95％置信区间[CI]4.1-5.1）和安全网设置（OR1.9，1.7-2.1）提供产妇护理的可能性更大。没有或更少的OBGYN和CNM的最低五分之一的FPs提供产妇护理的可能性（OR2.1，1.8-2.3）高于最高五分之一的FPs，有了更多的OBGYN和CNM。
结论：高需求地区的FPs，如农村和安全网设置，CNM或OBGYN较少的地区更有可能提供产妇护理，证明FPs在满足产妇护理机会有限的妇女需求方面的重要性。我们的研究结果强调了考虑FPs对产妇护理的贡献的重要性，因为组织将资源分配优先于最需要的领域。
方法：使用美国家庭医学认证委员会的考试申请调查数据，我们调查了FPs\'产妇保健服务提供与(1)人口统计学(性别，多年的实践，种族/种族)，(2)实践特征(大小，所有权,rurality),和(3)县级因素(育龄妇女的百分比，每100,000育龄女性的妇产科医生（OBGYN）和认证护士助产士（CNM）的数量）。我们进行了汇总统计和多变量逻辑回归分析。
结果：在样本中的59,903个FP中，7.5%提供产妇护理。在农村执业的FPs提供产妇护理的可能性是在城市地区执业的FPs的2.5倍。学术上的FPs（比值比[OR]4.6，95％置信区间[CI]4.1-5.1）和安全网设置（OR1.9，1.7-2.1）提供产妇护理的可能性更大。没有或更少的OBGYN和CNM的最低五分之一的FPs提供产妇护理的可能性（OR2.1，1.8-2.3）高于最高五分之一的FPs，有了更多的OBGYN和CNM。
结论：高需求地区的FPs，如农村和安全网设置，CNM或OBGYN较少的地区更有可能提供产妇护理，证明FPs在满足产妇护理机会有限的妇女需求方面的重要性。我们的研究结果强调了考虑FPs对产妇护理的贡献的重要性，因为组织将资源分配优先于最需要的领域。
