Cohen M M, Hammarstrand K M
Can Fam Physician. 1989 Feb;35:229-32.
Pap testing is one of the few effective preventive health practices available to primary care physicians. Yet we know little about how well this procedure is being done. Using data from the province of Manitoba's universal health insurance plan for the years 1976, 1978 and 1982, we determined the proportion of all Pap tests of women over 25 years of age performed by the various physician specialties; the percentage of physicians in each specialty who performed tests; and the mean number of tests per specialty group. We also determined the mean number of tests by age and training of the physician. The number of physicians performing Pap tests increased from 749 in 1976 to 780 in 1982. About 2% of Pap tests performed in the province were done by internists, 5% by general surgeons, about 33% by obstetrician/gynecologists, 40% by urban general practitioners, and 22% by rural general practitioners. Other physicians accounted for less than 0.2% of all tests. The mean number of Pap tests performed increased with increasing physician age up to age 60 and declined thereafter. Manitoba-trained physicians performed the highest rate of Pap testing, and this pattern was maintained over time. In 1982, only 22% of internists, 29% of general surgeons, and 78% of family physicians/general practitioners were performing tests. These results raise the question of why a significant number of physicians are not carrying out this effective preventive health practice.
巴氏涂片检查是基层医疗医生可采用的少数几种有效的预防性健康检查手段之一。然而，我们对该检查的执行情况知之甚少。利用马尼托巴省1976年、1978年和1982年全民健康保险计划的数据，我们确定了25岁以上女性的各类巴氏涂片检查中由不同专科医生完成的比例；各专科中进行检查的医生所占百分比；以及每个专科组的平均检查次数。我们还根据医生的年龄和培训情况确定了平均检查次数。进行巴氏涂片检查的医生人数从1976年的749人增加到了1982年的780人。该省约2%的巴氏涂片检查由内科医生完成，5%由普通外科医生完成，约33%由妇产科医生完成，40%由城市全科医生完成，22%由农村全科医生完成。其他医生完成的检查占所有检查的比例不到0.2%。巴氏涂片检查的平均执行次数随着医生年龄增长至60岁而增加，此后则下降。在马尼托巴省接受培训的医生进行巴氏涂片检查的比例最高，且这种模式长期保持。1982年，只有22%的内科医生、29%的普通外科医生以及78%的家庭医生/全科医生在进行检查。这些结果引发了一个问题，即为什么有相当数量的医生没有开展这种有效的预防性健康检查。
