Carcaise-Edinboro Patricia, Bradley Cathy J
Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
Med Care. 2008 Jul;46(7):738-45. doi: 10.1097/MLR.0b013e318178935a.
Screening reduces incidence and mortality from colorectal cancer (CRC). Despite improved access, screening is suboptimal and disparate among minority groups. Quality of patient-provider communication may impact CRC screening.
We examined the relationship between patient-provider communication and socioeconomic variables on the receipt of CRC screening using data from the Medical Expenditure Panel Survey.
All persons age 50 years or older (N = 8488).
Dependent measures were receipt of CRC screening, fecal occult blood testing, and colonoscopy or sigmoidoscopy. Independent variables included demographic characteristics, patient language, and patient-provider communication measures from the Consumer Assessment of Health Plan survey.
Patients who felt they had sufficient time with their healthcare provider were more likely to be screened for CRC. Receiving adequate explanation of healthcare needs from provider was a significant predictor of fecal occult blood testing screening. In addition, persons with less than a high school education, the uninsured, or those with low income were associated with reduced likelihood of receiving CRC screening. Asians and Hispanics had a significantly reduced likelihood of receiving screening in comparison with whites; however, after adjusting for language, no significant differences for race or ethnicity were observed.
Adequate time with a healthcare provider and receiving sufficient explanation of the healthcare processes by providers may improve screening rates. Patient-provider communication may be improved by addressing language needs of non-English speaking patients. Overall improved communication may increase CRC screening rates in underserved populations.
筛查可降低结直肠癌（CRC）的发病率和死亡率。尽管获得筛查的机会有所改善，但筛查情况仍不理想，且少数群体之间存在差异。医患沟通质量可能会影响CRC筛查。
我们使用医疗支出小组调查的数据，研究了医患沟通与社会经济变量对接受CRC筛查的影响之间的关系。
所有50岁及以上的人群（N = 8488）。
因变量为是否接受CRC筛查、粪便潜血试验以及结肠镜检查或乙状结肠镜检查。自变量包括人口统计学特征、患者语言以及来自消费者健康计划调查的医患沟通指标。
认为自己与医疗服务提供者有足够时间交流的患者更有可能接受CRC筛查。从医疗服务提供者那里获得对医疗需求的充分解释是粪便潜血试验筛查的一个重要预测因素。此外，未接受过高中教育、未参保或低收入人群接受CRC筛查的可能性较低。与白人相比，亚洲人和西班牙裔接受筛查的可能性显著降低；然而，在对语言进行调整后，未观察到种族或族裔方面的显著差异。
与医疗服务提供者有足够的交流时间以及从医疗服务提供者那里获得对医疗过程的充分解释可能会提高筛查率。通过满足非英语患者的语言需求，可以改善医患沟通。总体而言，改善沟通可能会提高服务不足人群的CRC筛查率。
