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流动乳腺摄影:对自我转诊以惠及医疗服务不足女性的评估。

Mobile mammography: assessment of self-referral in reaching medically underserved women.

作者信息

Peek Monica E, Han Jini

机构信息

Division of General Internal Medicine, The University of Chicago, IL 60637, USA.

出版信息

J Natl Med Assoc. 2007 Apr;99(4):398-403.

Abstract

BACKGROUND

Mobile mammography can be useful in reaching medically underserved women. However, it is not known whether self-referral for mobile mammography is the best approach for reaching the most vulnerable populations.

OBJECTIVES

  1. To describe the community outreach patterns of a county-sponsored mobile mammography unit, 2) To characterize the follow-up patterns for women with abnormal screening mammograms, and 3) to identify reasons why women screened on mobile units seek follow-up care outside of the safety-net system.

METHODS

We prospectively followed women aged > or = 40 years who received mobile mammograms using electronic records and medical chart review, and surveyed women who had no evidence of diagnostic follow-up. We also reviewed administrative records to determine outreach patterns of the mobile mammography units.

RESULTS

Seventy-five percent of mobile visits were with community-based organizations or community health centers. At least one quarter of women chose to follow-up outside of the safety-net for evaluation of abnormal screening mammograms. Of these, nearly 40% reported having insurance or a private physician as the primary reason for having diagnostic evaluation outside of the public hospital system.

CONCLUSIONS

Despite serving primarily community-based facilities, self-referral for mobile mammography may not optimally target medically underserved women most in need of breast cancer screening.

摘要

背景

移动乳腺摄影在为医疗服务不足的女性提供服务方面可能很有用。然而,尚不清楚自我推荐进行移动乳腺摄影是否是接触最脆弱人群的最佳方式。

目的

1)描述一个县资助的移动乳腺摄影单位的社区外展模式,2)描述乳腺摄影筛查异常的女性的后续模式,3)确定在移动单位接受筛查的女性在安全网系统之外寻求后续护理的原因。

方法

我们前瞻性地跟踪了年龄≥40岁且接受移动乳腺摄影的女性,使用电子记录和病历审查,并对没有诊断性后续证据的女性进行了调查。我们还审查了行政记录以确定移动乳腺摄影单位的外展模式。

结果

75%的移动就诊是与社区组织或社区卫生中心合作进行的。至少四分之一的女性选择在安全网之外进行后续检查,以评估乳腺摄影筛查异常的情况。其中,近40%的人报告称有保险或私人医生是在公立医院系统之外进行诊断评估的主要原因。

结论

尽管主要服务于社区设施,但自我推荐进行移动乳腺摄影可能无法最佳地针对最需要乳腺癌筛查的医疗服务不足的女性。

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