Curbow Barbara A, Dailey Amy B, King-Marshall Evelyn C, Barnett Tracy E, Schumacher Jessica R, Sultan Shahnaz, George Thomas J
At the time of the study, Barbara A. Curbow, Evelyn C. King-Marshall, and Tracy E. Barnett were with the Department of Behavioral Science and Community Health, University of Florida, Gainesville. Jessica R. Schumacher was with the Department of Health Services Research, Management & Policy, Gainesville. Shahnaz Sultan was with the North Florida/South Georgia Veterans Affairs Medical Center, Department of Medicine, Gainesville. Thomas J. George Jr was with the Department of Medicine, University of Florida, Gainesville. Amy B. Dailey was with the Department of Health Sciences, Gettysburg College, Gettysburg, PA.
Am J Public Health. 2015 Apr;105(4):e103-11. doi: 10.2105/AJPH.2014.302347. Epub 2015 Feb 25.
We aimed to highlight sociodemographic differences in how patients access colonoscopy.
We invited all eligible patients (n = 2500) from 2 academy-affiliated colonoscopy centers in Alachua County, Florida (1 free standing, 1 hospital based), to participate in a precolonoscopy survey (September 2011-October 2013); patients agreeing to participate (n = 1841, response rate = 73.6%) received a $5.00 gift card.
We found sociodemographic differences in referral pathway, costs, and reasons associated with obtaining the procedure. Patients with the ideal pathway (referred by their regular doctor for age-appropriate screening) were more likely to be Black (compared with other minorities), male, high income, employed, and older. Having the colonoscopy because of symptoms was associated with being female, younger, and having lower income. We found significant differences for 1 previously underestimated barrier, having a spouse to accompany the patient to the procedure.
Patients' facilitators and barriers to colonoscopy differed by sociodemographics in our study, which implies that interventions based on a single facilitator will not be effective for all subgroups of a population.
我们旨在突出患者在接受结肠镜检查方式上的社会人口统计学差异。
我们邀请了佛罗里达州阿拉楚阿县2家学术附属结肠镜检查中心（1家独立中心，1家医院附属中心）的所有符合条件的患者（n = 2500）参与结肠镜检查前的调查（2011年9月至2013年10月）；同意参与的患者（n = 1841，应答率 = 73.6%）可获得一张5美元的礼品卡。
我们发现患者在转诊途径、费用以及接受该检查的相关原因方面存在社会人口统计学差异。具有理想转诊途径（由其常规医生因适龄筛查而转诊）的患者更可能是黑人（与其他少数族裔相比）、男性、高收入、有工作且年龄较大。因出现症状而接受结肠镜检查与女性、年轻以及低收入相关。我们发现了一个此前被低估的障碍存在显著差异，即有配偶陪同患者接受检查。
在我们的研究中，患者接受结肠镜检查的促进因素和障碍因社会人口统计学特征而异，这意味着基于单一促进因素的干预措施对人群中的所有亚组并非都有效。
