Admitting privileges and hospital‐based care after presenting for abortion: A retrospective case series

Abstract

Objective To examine the pathways of care for abortion patients transferred or referred to emergency departments (EDs) or hospitals before and after abortion‐providing physicians obtained hospital admitting privileges. Data Sources This case series was based on retrospective chart review at three abortion clinics in which physicians had obtained admitting privileges in the previous 5 years. Study Design We identified patients who were transferred or referred to a hospital or ED. Patients were grouped according to the pathway by which their care was transferred or referred to the ED/hospital. Principal Findings Both before and after admitting privileges, the majority of patients were referred to a hospital before the abortion was attempted and most were for suspected ectopic pregnancy or to perform the abortion in a hospital. Direct ambulance transfer from the facility to the ED/hospital was the least common pathway. We observed few changes in practice from before to after admitting privileges. Preexisting mechanisms of coordination and communication facilitated care that was tailored for the specific patient. Conclusions We did not find evidence that physician admitting privileges influenced the pathways through which abortion patients obtain hospital‐based care, as existing mechanisms of collaboration between hospitals and abortion facilities allowed for management of patients who sought hospital‐based care.

Health-related quality of life of hospitalized COVID-19 survivors: An initial exploration in Nanning city, China

“…Some state-level policies, known as targeted regulation of abortion providers (TRAP) laws, impose onerous requirements on abortion providers and abortion-providing facilities, and are associated with decreased abortion provider availability in the U.S. ( Grossman et al, 2014 ). Two common TRAP laws - requiring abortion providers to have hospital admitting privileges and requiring abortion facilities to meet ambulatory surgical center standards - do not appear to increase patient safety ( Berglas et al, 2018 ; Roberts et al, 2018 ; Upadhyay et al, 2019b ). However, such laws can lead to clinic closures, which, in turn, can cause abortion care delays, increased travel, and financial costs for patients ( Gerdts et al, 2016 ; Grossman et al, 2014 ).…”