Conocimiento del parto humanizado en Colombia en residentes y ginecólogos / Knowledge of humanized childbirth in Colombian residents and gynecologists

Resumen OBJETIVO: Identificar, mediante una encuesta, el conocimiento de especialistas y residentes de Ginecología y Obstetricia de los beneficios de la atención respetuosa y digna a la paciente en el momento del parto. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo, transversal y prospectivo efectuado en una muestra de ginecoobstetras y residentes de diferentes universidades e instituciones de Colombia a quienes se aplicó, entre los meses de diciembre de 2021 a agosto de 2022, un instrumento estructurado de manera individual, presencial o virtual. RESULTADOS: Se obtuvieron 343 respuestas. El 51% de la muestra fue de especialistas con más de dos años de experiencia. El 37.2% de los residentes cursaba el tercer y 20.2% el segundo año. Más de la mitad de los encuestados no recibió ni recibe educación del tema. Se identificó un vacío en el conocimiento y su implementación. La totalidad de la muestra no reconoció algún beneficio materno o neonatal. El 86.3% consideró que no existe contraindicación para la implementación del parto digno y respetuoso y el 94.8% manifestó una correlación entre la desinformación y su baja implementación. El 69.4% de la muestra conocía y ponía en práctica el plan de parto en su práctica diaria. CONCLUSIONES: De la muestra analizada se concluye que hay desinformación acerca de los beneficios maternos y neonatales del parto digno y respetuoso por parte de residentes y especialistas de Ginecología y Obstetricia. Por lo tanto, es necesario aumentar los contenidos del tema a los programas de educación. Además, estandarizar los protocolos ajustados que faciliten su ejecución e implementación.

Abstract OBJECTIVE: To identify, by means of a survey, the knowledge of specialists and residents in Gynaecology and Obstetrics of the benefits of respectful and dignified care for the patient at the time of delivery. MATERIALSAND METHODS: Observational, descriptive, cross-sectional, and prospective study carried out on a sample of obstetrician-gynecologists and residents from different universities and institutions in Colombia to whom a structured instrument was applied individually, in person or online, between December 2021 and August 2022. RESULTS: 343 responses were obtained. Fifty-one percent of the sample were specialists with more than two years of experience. 37.2% of the residents were in their third year and 20.2% were in their second year. More than half of the respondents did not and do not receive any education on the subject. A gap in knowledge and implementation were identified. The entire sample did not recognize any maternal or neonatal benefit. 86.3% considered that there is no contraindication to the implementation of respectful and dignified childbirth and 94.8% expressed a correlation between misinformation and low implementation of respectful and dignified childbirth. 69.4% of the sample were aware of and implemented the birth plan in their daily practice. CONCLUSIONS: From the sample analyzed, it is concluded that there is misinformation about the maternal and neonatal benefits of dignified and respectful childbirth on the part of Gynaecology and Obstetrics residents and specialists. Therefore, it is necessary to increase the content of the subject in education programs. In addition, it is necessary to standardize adjusted protocols that facilitate their execution and implementation.

Opinions, Attitudes, and Prescribing Practices of Oral Contraceptive Pills of General Practitioners and Gynecologists in India

Background:To study the prescription behavior of oral contraceptive pills (OCPs) by physicians, gynecologists, and alternative medicine practitioners (AMPs). Materials and Methods?Close-ended questionnaire-based cross-section study was performed between 1st September 2012 and 28th February 2014 in three groups of responders, i.e., AMP, general medical practitioners (GMPs), and obstetricians and gynecologists (ObGy). A stratified random cluster sample was used. Data of 400 subjects in all three groups were obtained using both univariate and multi-variate sophisticated statistical analyses for analyzing attitude and practices and were recorded on an ordinal scale using appropriate non-parametric test. Results?Of the 1,237 subjects surveyed, 400 completed questionnaires were received from each of the three groups viz; AMPs, GMPs, and ObGy. Remaining 37 incomplete questionnaires were not included in the final analysis. Conclusion?There are equal misconceptions regarding OCPs among users and prescribing physicians. Preference for OCPs in married and unmarried women is also equally low. OCP usage and their prescription practices can be improved by removing potential barriers, developing public–private partnership, and training promoters.

Representações sociais de aborto para ginecologistas e obstetras da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil / Social representations of abortion for gynecologists and obstetricians in the Metropolitan Region of Belo Horizonte in the State of Minas Gerais, Brazil

Resumo O objetivo deste estudo foi identificar e analisar as representações sociais de aborto para ginecologistas e obstetras. Para tal, foram realizadas entrevistas semiestruturadas com 20 ginecologistas e obstetras, 10 homens e 10 mulheres de 34 a 67 anos de idade, que atuavam em hospitais da Região Metropolitana de Belo Horizonte, Minas Gerais. Os resultados apontam que o aborto é recorrente no cotidiano dos entrevistados, mobilizando a elaboração de representações sociais que os ajudam a torná-lo um objeto familiar. Tipologicamente, as representações identificadas foram representações sociais polêmicas. A maioria dos participantes objetivava o aborto como Decisão/Direito, o ancorando em valores básicos, como a liberdade, que orientavam a realização do aborto e o apoio à sua legalização. Paralelamente, outra parcela dos participantes objetivou o aborto enquanto Assassinato, o ancorando em valores básicos considerados inquestionáveis, como a vida, o que implicava na defesa do feto e na objeção de consciência à realização do aborto.

Abstract The scope of this study was to identify and analyze the social representations of abortion for gynecologists and obstetricians. The methodology used was the Semi-Structured Interview with 20 gynecologists and obstetricians (10 males and 10 females) from 34 to 67 years of age, who worked in hospitals in the Metropolitan Region of Belo Horizonte in the State of Minas Gerais. The results showed that abortion is recurrent in the daily routine of the interviewees, mobilizing the elaboration of social representations that help them to make it a familiar topic. Typologically, the representations identified were polemic social representations. Most participants objectified the abortion as Decision/Right, anchoring it in basic values, such as liberty, which oriented the practice of abortion and support its legalization. In parallel, another group of participants configured abortion as Murder, anchoring it in basic values considered unquestionable, such as life, which implied in the defense of the fetus, and conscientious objection to the practice of abortion.

Interest in and practices related to gynecologic oncology among members of the Brazilian Federation of Associations of Gynecology and Obstetrics / Interesse e práticas relacionadas à oncologia ginecológica entre os membros da Federação Brasileira de Associações de Ginecologia e Obstetrícia

Abstract Objective The present study aims to obtain basic demographic information, the level of interest and of training in gynecology oncology among Brazilian obstetricians and gynecologists (OB-GYNs) to create a professional profile. Methods An online questionnaire was sent to 16,008 gynecologists affiliated to the Brazilian Federation of Associations of Gynecology and Obstetrics (FEBRASGO, in the Portuguese acronym). We considered gynecologists dedicated to gynecologic oncology (OB-GYNs ONCO) those who self-reported that > 50% of their daily practice consists in working with women's cancer care. Results A total of 1,608 (10%) of 16,008 FEBRASGO members responded. The OBGYNs are concentrated in the southern and southeastern states of Brazil. Gynecologic oncology was considered the 8th greatest area of interest in gynecology among the OBGYNs. A total of 95 (5.9%) of the OB-GYNs were considered OB-GYNs ONCO. Obstetricians and gynecologists are actively engaged in cancer care: > 60% of them dedicate up to 25% of their daily practice to oncology. The role of the physicians in screening and prevention, diagnosis, in the treatment of precancerous lesions, and in low complexity surgical procedures is notably high. Gynecologists dedicated to gynecologic oncology in Brazil have a heterogeneous, nonstandardized and short training period in gynecologic oncology. These professionals had a more significantly role in performing medium- and high-complexity operations compared with OB-GYNs (65.2% versus 34%, and 47.3% versus 8.4%, respectively). Conclusion The role of OB-GYNs and of OB-GYNs ONCO appears to be complementary. Obstetricians and gynecologists actmore often in screening and prevention and in low-complexity surgical procedures, whereas OB-GYNs ONCO are more involved in highly complex cases. Strategies to raise standards in cancer training and to encourage the recognition of gynecologic oncology as a subspecialty should be adopted in Brazil.

Resumo Objetivo Opresente estudotemcomo objetivo obter informações demográficas básicas, o nível de interesse e de treinamento em ginecologia oncológica entre obstetras e ginecologistas (OB-GYNs) brasileiros para criar um perfil destes profissionais. Métodos Umquestionário online foi enviado a 16.008 ginecologistas filiados à Federação Brasileira de Associações de Ginecologia e Obstetrícia (FEBRASGO). Nós consideramos ginecologistas dedicados à oncologia ginecológica (OB-GYNsONCO) aqueles que referiram atuar em > 50% de sua prática diária com o tratamento do câncer feminino. Resultados Um total de 1.608 (10%) dos 16.008 membros da FEBRASGO responderam ao questionário. Os OB-GYNs estão concentrados nos estados do sul e sudeste do Brasil. A oncologia ginecológica foi considerada a 8ª área de maior interesse em ginecologia entre os OB-GYNs. Um total de 95 (5,9%) dos OB-GYNs foram considerados ginecologistas dedicados à oncologia ginecológica (OB-GYNs ONCO). Obstetras e ginecologistas estão ativamente envolvidos no tratamento do câncer: > 60% deles dedicam até 25% de sua prática diária à oncologia. O papel dosmédicos na triageme na prevenção, no diagnóstico, no tratamento de lesões pré-cancerosas e em procedimentos cirúrgicos de baixa complexidade é notavelmente alto. Ginecologistas dedicados à oncologia ginecológica no Brasil têm umperíodo de treinamento emoncologia ginecológica heterogêneo, não padronizado e curto. Estes profissionais tiveram um papel mais significativo na realização de operações de média e alta complexidade em comparação com OB-GYNs (65,2% versus 34%, e 47,3% versus 8,4%, respectivamente). Conclusão Os papéis dos OB-GYN e dos OB-GYNs ONCO parecem ser complementares. Os OB-GYNs frequentemente atuam emtriageme prevenção e em procedimentos cirúrgicos de baixa complexidade, enquanto os OB-GYNs ONCO estão mais envolvidos em casos demais alta complexidade. Estratégias para elevar os padrões de treinamento em oncoginecologia e incentivar o reconhecimento da oncologia ginecológica como uma subespecialidade devem ser adotadas no Brasil.

No scalpel vasectomy: a cross-sectional study of knowledge, attitude and practice of gynaecologists

Background: In spite of no scalpel vasectomy (NSV) being cheaper and safer, female sterilisations account for the majority of sterilisations performed worldwide. Research has focussed more on the “demand” and less on the “provider” side. Gynaecologists can be front-runners for the cause of population control in India. Hence, authors decided to estimate the knowledge of gynaecologists, their attitude and prevalent practice of NSV.Methods: Cross-sectional study. Interviewer-administered questionnaire used for face-to-face data collection from gynecologists registered with the Pune Obstetric and Gynecological Society.Results: Out of 447 gynecologists, 158 (35.3%) were males and 289 (64.7%) females. Mean age was 46.3 years ± 12.1 years, (range 24-80 years). Only 14 (3.1%) were trained in performing NSV. Only a minority knew about type of anaesthesia used (1.8%) and number of accesses needed (48.1%) for NSV. Only 40.7% and 18.1% knew about time to resume sexual activity and number of ejaculations to be covered by additional contraceptives after NSV respectively. More than half [258 (57.7%)] were willing to undergo training in NSV. Among those unwilling for training, female and older gynecologists (≥40 years) significantly outnumbered male and younger gynecologists (76.5% Vs. 23.5%; p=0.000 and 78.8% Vs. 21.2% respectively; p=0.000). Majority (79.9%) referred a couple willing for NSV to surgeons or urologists or advised female sterilization (17%).Conclusions: Knowledge of gynecologists about NSV was inadequate. Minority were trained in performing NSV. Male and younger gynecologists were willing to undergo training in NSV. Most preferred practices were referring couples elsewhere or advising female sterilization.

Oral Ferric Pyrophosphate Formulation Utilization Surveillance Study To Assess Clinical Impact On Hemoglobin Levels: Maxiim-Hemoglobin Study

After hemorrhage, anemia is the most common cause of maternal mortality and leading cause of maternal morbidity in India. Theprevalence rates of anemia in pregnancy in India is estimated to be >50%. Iron deficiency anemia (IDA) is the most commontype of anemia in pregnancy in India, which I can be as high as 80–90%.Aims and Objectives: The present survey was initiated in pursuit of analyzing the effectiveness and safety of oral ferricpyrophosphate (FPP) formulation given once to twice daily for treatment and prophylaxis of IDA in pregnancy.Materials and Methods: This was a questionnaire-based retrospective survey. Each gynecologist was given this survey bookletcontaining questionnaire. Clinical response was assessed by measuring rise in mean hemoglobin (Hb) levels at baseline, week4, and week 8, after giving oral FPP formulation for 8 weeks.Results: A total of 60 gynecologists participated and completed the survey, which involved 1073 pregnant subjects and patientssuffering from IDA (864 patients, i.e., 80%). Mean Hb level at baseline was found to be 8.98 g/dl, 10.03 at week 4, and 10.99 atweek 8. Thus, rise of Hb from baseline to week 8 was found to be 2.01 g/dl. Adverse events were reported in only 10 patients(<0.09%), none requiring discontinuation of therapy. 98% of the participants agreed good acceptability of oral FPP formulation.Conclusion: Findings of the present survey suggests that oral FPP formulation therapy can serve as potent choice of therapyfor IDA in pregnancy, both therapeutically and prophylactically

Factors associated with the prescription of vaginal pessaries for pelvic organ prolapse

OBJECTIVE: To identify the factors associated with the prescription of vaginal pessaries (VPs) as a conservative treatment for pelvic organ prolapse (POP). METHODS: A cross-sectional study was performed during two annual urogynecology and general obstetrics and gynecology meetings in 2017 (São Paulo, SP, Brazil). A 19-item deidentified questionnaire regarding experiences and practices in prescribing VPs for POP patients was distributed among gynecologists. Our primary outcome was the frequency of prescribing VPs as a conservative treatment for POP. The reasons for prescribing or not prescribing VPs were also investigated. Univariate and multivariate analyses with crude and adjusted odds ratios (ORs) were performed for variables associated with the prescription of pessaries. RESULTS: Three hundred forty completed surveys were analyzed. Half of the respondents (53.53%) were between 30-49 years old; most of them were female (73.53%), were from the Southeast Region (64.12%), were trained in obstetrics and gynecology (80.24%) or urogynecology (61.18%) and worked in private offices (63.42%). More than one-third (36.48%) attended four or more POP cases/week, and 97.65% (n=332) had heard or knew about VPs for POP; however, only 47.06% (n=160) prescribed or offered this treatment to patients. According to the multivariate analysis, physicians aged 18-35 years (OR=1.97[1.00-3.91]; p=0.04), those who participated in a previous urogynecology fellowship (OR=2.34[1.34-4.09]; p<0.01), those with relatively high volumes of POP cases (4 or +) (OR=2.23[1.21-4.47]; p=0.01) and those with PhD degrees (OR=2.75[1.01-7.54]; p=0.05) prescribed more pessaries. CONCLUSIONS: Most gynecologists did not prescribe VPs. Younger physician age, participation in a previous urogynecology fellowship, a PhD degree, and a relatively high volume of POP cases were associated with increased VP prescription rates.

Conocimientos, actitudes y prácticas sobre aborto en una muestra de médicos gineco-obstetras de Ecuador / Knowledge, attitudes and practices regarding abortion in a sample of obstetrician-gynecologists from Ecuador

Objetivos: Determinar el nivel de conocimientos, actitudes y prácticas en una muestra intencionada de médicos gineco-obstetras líderes provinciales de la Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO) sobre el aborto inducido. Diseño: Estudio transversal, correlacional, de corte prospectivo y analítico. Institución: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participantes: Médicos gineco-obstetras líderes provinciales de FESGO. Metodología: En una muestra intencionada de 33 médicos gineco-obstetras se aplicó una encuesta estructurada validada y basada en experiencias de la región, acerca de datos generales y sociodemográficos del encuestado, conocimientos teóricos sobre la epidemiología del aborto y la muerte materna, actitudes con relación del manejo del aborto inseguro, y la práctica de prescripción de misoprostol y tratamiento quirúrgico por aspiración. Principales medidas de resultados: Nivel de conocimientos, actitudes y prácticas. Resultados: La población encuestada tenía promedio de edad de 49 años, 16 años de práctica, con relación estable, hijos y religión declarada. Consideraron de alta prioridad la muerte materna por aborto, pues atendían pacientes públicas y privadas con intención de aborto inducido frecuente y uso de misoprostol previo. Consideraron la ampliación de motivos para aborto con la proyección de reducción de mortalidad, aunque los casos aumentaran. En su mayoría consideraron suficientes sus conocimientos de derechos reproductivos, se sentían solventes respecto a la consejería en misoprostol, aunque la satisfacción alta respecto a consejería de aborto inducido fue apenas en 51%. Conclusiones: Los líderes provinciales de esta muestra intencionada conocían la temática del aborto y su atención integral. Los conocimientos fueron altos, aunque las actitudes y prácticas resultaron diversas, con respuestas que sugieren mayor sensibilización y capacitación. Nuevos estudios necesitan ser realizados en una población más amplia de gineco-obstetras federados, así como intervenciones educativas y de sensibilización para mejorar la calidad de atención del aborto.

Objectives: To determine knowledge, attitudes and practices regarding abortion in an intentioned sample of obstetrician/gynecologists who are provincial leaders of the Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Design: Prospective, correlational, cross-sectional, and analytical survey. Setting: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participants: FESGO obstetrician/gynecologists provincial leaders. Methods: A structured and validated survey was applied to an intentional sample of 33 obstetrician/gynecologists. The survey was based on experiences in the region, general and demographic information of the respondent, theoretical knowledge about the epidemiology of abortion and maternal death, attitudes about the management of unsafe abortion, and practice on misoprostol prescription and surgical aspiration. Main outcome measures: Knowledge, attitude and practices. Results: The survey respondents were 49 years old average, had 16 years of medical practice, and stable family relations, with declared children and religion. They considered maternal death due to abortion of high priority be-cause they attended public and private patients with frequent history of induced abortion and use of misoprostol. They also considered the expansion of reasons for abortion in the light of a potential reduction in mortality, even if the number of cases increased. Most considered sufficient their knowledge on reproductive rights and felt proficient with respect to counseling on misoprostol, although high satisfaction on induced abortion counseling was just 51%. Conclusions: Provincial leaders of this sample knew about abortion and its comprehensive care. Knowledge was high, but attitude and practices were diverse and require more awareness and training. Further studies are needed in a b broader federated population of obstetrician/ gynecologists. Educational and sensitizing interventions are needed to improve the quality of abortion care.

Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists.

In the recent decades, periodontal disease has been identified as a risk factor for pre-term deliveries. Hence, it is important to evaluate the awareness of health-care providers of the association between periodontal diseases and pre-term birth. A self-administered questionnaire was distributed to random samples representing general medical practitioners (GMPs), general dental practitioners (GDPs) and Gynecologists for this study. A knowledge score was calculated for correct answers to 11 survey questions related to oral health effects during pregnancy and compared among the three groups. In this study, 133 physicians, 135 dentists and 100 Gynecologists completed the questionnaire. More GDPs (67.4%) than GMPs (56.4%) and Gynecologists (63%) reported there was an association between periodontal disease and pre-term low birth weight. Efforts to increase this awareness may prove valuable in improving preventive care during pregnancy.

Awareness of association between periodontitis and PLBW among selected population of practising gynecologists in Andhra Pradesh.

Context: Preterm low-birth-weight (PLBW) infants are at a higher risk for a number of acute and chronic disorders. Studies point to an association between periodontal infection and increased rates of preterm birth, and pregnant mothers with periodontal diseases are at increased risk of subsequent preterm birth or low birth weight. However, the awareness level of gynecologists about this relationship is unknown. Aims: The aim of the present survey was to assess the awareness about the effects of periodontal disease on pregnancy among practicing gynecologists, and also compare such awareness between gynecologists in two places-Khammam (a district headquarter) and Hyderabad (a state capital). Settings and Design: Random, cross-sectional study in a population of practicing gynecologists from Andhra Pradesh. Materials and Methods: A random study population was selected from the practicing gynecologists in Khammam and Hyderabad. Sixty practicing gynecologists, 30 each in Khammam and Hyderabad, were approached and they consented to join the study. Data were collected in questionnaire format from the subject population. Collected data were statistically analyzed. Chi-square test with Yates correction was used to analyze the data. A " P" value of <0.05 was taken as a significant difference. Results: 73.3% of the gynecologists said that their patients complain of bleeding gums, swellings and mobility. 58.3% of the gynecologists were aware that gum diseases occur at a higher rate in pregnant females. 38.3% of the gynecologists were aware that periodontal diseases can affect the outcome of delivery. No significant difference was found between the awareness levels of gynecologists in Khammam and in Hyderabad. Conclusions: There is a need for interdisciplinary approach for the prevention of PLBW cases by the integration of periodontal care into obstetric management. Effort should be made to increase awareness among the gynecologists.

Prescription Patterns of Anti-osteoporosis Medications by Gynecologists / 대한폐경학회지

OBJECTIVES: To describe prescription patterns by gynecologists for osteoporosis therapy and to compare with the prescription patterns by physicians of other medical specialties based on the data from the Health Insurance Review and Assessment Service. METHODS: A total of 28,568 prescription claims by gynecologists of 633,870 prescription claims by physicians with medications for osteoporosis alone or medications for other indications, including osteoporosis, were analyzed. The medications for osteoporosis alone were, selective estrogen receptor modulators (SERMs), calcitonin (injection or nasal spray), vitamin K2, ipriflavone, and fluoride. The medications for other indications including osteoporosis were estrogen, tibolone, testosterone, calcium, calcium-vitamin D complex, vitamin D, and oxymetholone. RESULTS: Anti-osteoporosis medications were prescribed by 4.7% of gynecologists. Calcium and vitamin D were the most commonly prescribed medications by gynecologists (60.7%), followed by hormones, including tibolone (44%). Bisphosphonates, including bisphosphonate complex, were prescribed by 27.5% of gynecologists and SERMs were prescribed by 3.6% of gynecologists. Amongst all prescribers, the percentage of gynecologists was highest for hormones (50.6%), followed by tibolone (31.0%). When both medications were combined, the percentage of gynecologists among prescribers was 81.6%. The combination rate of calcium with other anti-osteoporosis medications was highest in gynecologists among prescribers of medical specialties (34.1%). CONCLUSION: A very small percentage of gynecologists prescribed anti-osteoporosis medications, while calcium, vitamin D, and hormones, including tibolone, were commonly prescribed by gynecologists.

Prescription Patterns of Anti-osteoporosis Medications by Gynecologists / 대한폐경학회지

OBJECTIVES: To describe prescription patterns by gynecologists for osteoporosis therapy and to compare with the prescription patterns by physicians of other medical specialties based on the data from the Health Insurance Review and Assessment Service. METHODS: A total of 28,568 prescription claims by gynecologists of 633,870 prescription claims by physicians with medications for osteoporosis alone or medications for other indications, including osteoporosis, were analyzed. The medications for osteoporosis alone were, selective estrogen receptor modulators (SERMs), calcitonin (injection or nasal spray), vitamin K2, ipriflavone, and fluoride. The medications for other indications including osteoporosis were estrogen, tibolone, testosterone, calcium, calcium-vitamin D complex, vitamin D, and oxymetholone. RESULTS: Anti-osteoporosis medications were prescribed by 4.7% of gynecologists. Calcium and vitamin D were the most commonly prescribed medications by gynecologists (60.7%), followed by hormones, including tibolone (44%). Bisphosphonates, including bisphosphonate complex, were prescribed by 27.5% of gynecologists and SERMs were prescribed by 3.6% of gynecologists. Amongst all prescribers, the percentage of gynecologists was highest for hormones (50.6%), followed by tibolone (31.0%). When both medications were combined, the percentage of gynecologists among prescribers was 81.6%. The combination rate of calcium with other anti-osteoporosis medications was highest in gynecologists among prescribers of medical specialties (34.1%). CONCLUSION: A very small percentage of gynecologists prescribed anti-osteoporosis medications, while calcium, vitamin D, and hormones, including tibolone, were commonly prescribed by gynecologists.

Opinions of Obstetricians and Gynecologists in Kagoshima Prefecture about the Rules of Medical Services Based on the Health Insurance System in Japan and Learning about them in University Departments / 医学教育

The shortage of financial resources for medical services is an important social issue in Japan. To examine what obstetricians and gynecologists think about the rules of medical services based on the Japanese national health insurance system, questionnaires were sent in August 1999 to obstetricians and gynecologists in Kagoshima prefecture. Valid responses were obtained from 63% of questionnaire recipients, including 17 obstetricians and gynecologists of the Department of Obstetrics and Gynecology, Kagoshima University, 25 working at public hospitals, and 56 working at private hospitals. These physicians thought that medical services should be performed according to the rules based on the health insurance system. However, physicians at Kagoshima University or at public hospitals knew little about the rules as they had not been adequately instructed by senior doctors. Physicians working at private hospitals also reported that they had not been taught the rules during their postgraduate training at university hospitals. All respondents thought that the rules of medical services based on the health insurance system must be included in the postgraduate education system.