Comment on UCSF SINC-Based Contraceptive Performance Measures
The Self- Identified Need for Contraception, (SINC)-Based Contraceptive Performance measures, developed by the Person-Centered Reproductive Health Program (PCRHP) at UCSF, is a critically important tool in order to improve the quality of contraceptive provision while advancing person-centered contraceptive counseling.
Utilizing electronic Clinical Quality Measures (eCQM) in performance metrics is an innovative approach to capturing more accurate and comprehensive information regarding contraceptive provision, particularly by capturing and accounting for individuals who self-report a need for contraception. This is a necessary step forward from currently endorsed claims-based measures that do not account for patient-reported contraceptive need and holds the potential to avoid directive or coercive counseling practices and support autonomous contraceptive choice. The measure would provide key quality improvement information on screening for contraceptive need and fulfilling those needs, particularly for Title X clinics who often serve individuals experiencing barriers in accessing contraceptive care.
An area for potential improvement would be the inclusion of non-prescription contraceptive methods (e.g., withdrawal, fertility awareness, condoms) in order to fully capture the range of potential contraceptive desires and usage by patients, as currently the measure only includes moderately/most effective methods. Additionally, some attention should be given to expanding the measure to include individuals who are able to become pregnant who may also require contraceptive care that do not identify as a cisgender woman.
-Dr. Ellie Smith, Director of Measurement, Learning, and Evaluation
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