McPhee S J, Bird J A
Department of Medicine, University of California, San Francisco 94143-0320.
J Gen Intern Med. 1990 Sep-Oct;5(5 Suppl):S116-22. doi: 10.1007/BF02600856.
Data from several sources, including consumer surveys, physician surveys, and medical record audits, indicate that consumers do not receive cancer screening tests as recommended by the National Cancer Institute, the American Cancer Society, and the U.S. Preventive Services Task Force. Performance rates are consistently below published standards for all tests except Pap tests. Major reasons physicians do not perform the recommended tests include physician forgetfulness, disagreement with recommendations, lack of time, and patient refusal. Physicians also tend to overestimate their own performance rates. Barriers to screening test performance can be categorized into patient factors, physician factors, test factors, and health care delivery system factors. Interventions, such as computerized reminder systems, physician audits with feedback, and patient education and reminders, can be effective in promoting performance of such screening. Interventions that target both physician and patient may be particularly effective.
来自多个渠道的数据，包括消费者调查、医生调查和病历审计，表明消费者并未按照美国国家癌症研究所、美国癌症协会和美国预防服务工作组的建议接受癌症筛查测试。除巴氏试验外，所有测试的执行率一直低于公布的标准。医生不进行推荐测试的主要原因包括医生健忘、不同意推荐、时间不足和患者拒绝。医生也往往高估自己的执行率。筛查测试执行的障碍可分为患者因素、医生因素、测试因素和医疗保健提供系统因素。诸如计算机提醒系统、有反馈的医生审计以及患者教育和提醒等干预措施，在促进此类筛查的执行方面可能是有效的。针对医生和患者的干预措施可能特别有效。
