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伯明翰教学初级保健信托中心高危男性心血管筛查:“致命三联征”项目。

Cardiovascular screening for men at high risk in Heart of Birmingham Teaching Primary Care Trust: the 'Deadly Trio' programme.

机构信息

Department of Public Health, Heart of Birmingham Teaching Primary Care Trust, Bartholomew House, 142 Hagley Road, Birmingham B16 9PA, UK.

出版信息

J Public Health (Oxf). 2012 Mar;34(1):73-82. doi: 10.1093/pubmed/fdr052. Epub 2011 Jul 12.

Abstract

BACKGROUND

The Deadly Trio programme offered cardiovascular health checks to men over 40 in inner-city Birmingham. The aim was to increase diagnosis of diabetes, cardiovascular and kidney disease among this deprived and ethnically diverse population. Either patients' own general practitioners (GPs) were paid to provide health checks or patients were invited to an alternative provider.

METHODS

Routine data were sought from 68 participating practices. Logistic regression analysis was undertaken to determine the patient and practice factors associated with being screened and with being added to a disease register.

RESULTS

Data were obtained from 58 practices; 5871 (24.3%) of 24 166 eligible men were screened. Screening uptake was higher in those with a recorded phone number, South Asians and Blacks but lower in smokers. Compared to the alternative provider, uptake was higher among men registered with single-handed (but not multi-partner) GPs paid to provide health checks. South Asian, older and screened men were more often added to disease registers. Men with missing information and GP-screened men were less likely to be added to registers.

CONCLUSIONS

The programme achieved higher screening uptake and diagnosis of disease among minority ethnic men. Single-handed GPs paid to provide screening (and their patients) were more responsive than multi-partner practices.

摘要

背景

“死亡三重奏”项目为伯明翰市中心的 40 岁以上男性提供心血管健康检查。其目的是增加糖尿病、心血管疾病和肾脏疾病在这个贫困和种族多样化人群中的诊断率。这些患者可以选择由自己的全科医生(GP)提供健康检查服务并获得报酬,也可以选择其他服务提供者。

方法

从 68 家参与的诊所中获取了常规数据。采用逻辑回归分析确定与筛查和登记疾病相关的患者和诊所因素。

结果

从 58 家诊所获得了数据;在 24166 名符合条件的男性中,有 5871 名(24.3%)接受了筛查。有记录电话号码的男性、南亚人和黑人的筛查参与率较高,而吸烟者的筛查参与率较低。与其他服务提供者相比,由全职(而非多合作伙伴)GP 付费提供健康检查的男性的参与率更高。南亚裔、年龄较大和接受过筛查的男性更常被登记在疾病登记册中。信息缺失的男性和由 GP 筛查的男性被登记在疾病登记册中的可能性较低。

结论

该项目在少数民族男性中实现了更高的筛查参与率和疾病诊断率。付费提供筛查服务的单人执业 GP(及其患者)比多合作伙伴诊所的反应更为积极。

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