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医患沟通和及时获得预防服务。

Patient-provider communication and timely receipt of preventive services.

机构信息

Department of Health Services Administration, 3310 School of Public Health Building, University of Maryland, College Park, MD 20742-2611, USA.

出版信息

Prev Med. 2013 Nov;57(5):658-63. doi: 10.1016/j.ypmed.2013.08.034. Epub 2013 Sep 8.

Abstract

OBJECTIVE

To estimate the association between how patients rate their health care provider's communication and the receipt of six clinical preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP).

METHODS

This study used national data from the 2009 Medical Expenditure Panel Survey (MEPS). The samples (sizes vary by service) included individuals aged 18 years and older who have a usual source of care (USC). The outcomes indicated whether or not individuals received screening for breast cancer, cervical cancer, colon cancer, high cholesterol, hypertension, or were vaccinated against influenza per clinical guidelines. Multivariate logistic regression models were created for each dependent variable. The main independent variables consisted of ratings of four patient-provider communication behaviors.

RESULTS

In unadjusted analyses, respondents who rated their providers' communication higher reported greater utilization of preventive services. After controlling for confounding variables, only receipt of mammograms remained significantly associated with better communication (p<0.05). Screening for cervical cancer, colon cancer, high cholesterol, and influenza vaccination approached significance with better communication (p<0.10).

CONCLUSIONS

Patient-provider communication is associated with receipt of regular mammograms. Clinicians should consider their medical dialogue with patients as a stimulus for appropriate screenings and vaccinations.

摘要

目的

评估患者对其医疗服务提供者沟通能力的评价与接受美国预防服务工作组(USPSTF)和免疫实践咨询委员会(ACIP)推荐的六种临床预防服务之间的关联。

方法

本研究使用了 2009 年医疗支出面板调查(MEPS)的全国性数据。样本(各服务的大小不同)包括有常规医疗服务来源(USC)的 18 岁及以上人群。结果表示个人是否根据临床指南接受乳腺癌、宫颈癌、结肠癌、高胆固醇、高血压或流感疫苗的筛查。针对每个因变量创建了多变量逻辑回归模型。主要的独立变量包括对四种医患沟通行为的评价。

结果

在未调整的分析中,评价提供者沟通能力较高的受访者报告了更多的预防服务利用。在控制了混杂变量后,只有乳房 X 光检查的接受与更好的沟通显著相关(p<0.05)。与更好的沟通相关的宫颈癌、结肠癌、高胆固醇和流感疫苗接种的筛查接近显著(p<0.10)。

结论

医患沟通与定期乳房 X 光检查的接受有关。临床医生应将其与患者的医疗对话视为适当筛查和接种疫苗的刺激因素。

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