Barr J K, Franks A L, Lee N C, Herther P, Schachter M
Qualidigm (Connecticut Peer Review Organization), Middletown, Connecticut 06457, USA.
Prev Med. 2001 Dec;33(6):661-7. doi: 10.1006/pmed.2001.0942.
Relatively little is known about factors that predict ongoing participation in mammography screening at regular intervals. Members of managed care plans have access to this preventive service; yet, many still do not receive it routinely.
Using administrative data from HIP Health Plan of New York, a group model HMO, 24,215 women ages 50-80 years identified as having a screening mammogram during the baseline period were followed for 2 years to determine demographic and utilization factors that might be related to having a subsequent mammogram within the recommended time interval.
Of the 24,215 women with an index mammogram, 71.8;pc had a subsequent screening mammogram within 2 years. Women ages 65-74 years and those with Medicare coverage had the highest mammogram rates among the age and coverage categories. Number of primary care and gynecology physician visits was strongly related to having a subsequent mammogram. The average (mean) time between index and subsequent mammogram was 14.4 months.
The significance of health plan visits in subsequent mammography underscores the importance of physician-patient communication in a managed care plan and the integration of health plan members into the HMO delivery system. Even in this environment with equal access for all types of coverage, Medicaid members were less likely to receive this preventive service.
关于预测定期进行乳房X线筛查持续参与情况的因素,人们了解相对较少。管理式医疗计划的成员可以获得这种预防性服务;然而,许多人仍然没有定期接受该服务。
利用纽约HIP健康计划(一种团体模式的健康维护组织)的管理数据,对24215名年龄在50 - 80岁之间、在基线期被确定进行过乳房X线筛查的女性进行了为期2年的跟踪,以确定可能与在推荐时间间隔内进行后续乳房X线检查相关的人口统计学和使用因素。
在24215名进行过首次乳房X线检查的女性中,71.8%在2年内进行了后续的乳房X线筛查。在年龄和保险类别中,65 - 74岁的女性以及有医疗保险覆盖的女性乳房X线检查率最高。初级保健和妇科医生的就诊次数与进行后续乳房X线检查密切相关。首次和后续乳房X线检查之间的平均时间为14.4个月。
健康计划就诊在后续乳房X线检查中的重要性凸显了管理式医疗计划中医患沟通以及将健康计划成员融入健康维护组织服务体系的重要性。即使在这种所有类型保险覆盖机会均等的环境中,医疗补助计划的成员接受这种预防性服务的可能性仍然较小。