Sakellariou Dikaios, Rotarou Elena S
School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom.
Department of Economics, University of Chile, Santiago, Chile.
PLoS One. 2017 May 1;12(5):e0176270. doi: 10.1371/journal.pone.0176270. eCollection 2017.
Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile.
We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram).
Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased.
This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population.
研究表明，与非残疾女性相比，残疾女性在获取和使用医疗服务方面面临更多挑战。然而，对于残疾女性癌症筛查服务的利用情况，人们了解得相对较少。本研究通过调查智利残疾女性的巴氏试验和乳房X线摄影的利用情况来填补这一空白。
我们使用了来自2015年全国代表性调查的横断面数据。最初，我们采用逻辑回归来检验残疾女性和非残疾女性之间巴氏试验（66281例观察对象）和乳房X线摄影（35294例观察对象）利用率的差异。接下来，使用逻辑回归来调查影响残疾女性癌症筛查服务利用率的人口统计学、社会经济和健康相关因素（样本量：巴氏试验为5823例观察对象，乳房X线摄影为5731例观察对象）。
残疾女性接受筛查测试的可能性低于非残疾女性。对于巴氏试验和乳房X线摄影，多变量回归模型显示，居住在农村地区、受过高等教育、隶属于私人健康保险公司、自我健康评估得分良好以及正在接受其他疾病治疗与较高的利用率相关。另一方面，单身、无工作以及收入较高与较低的利用率相关。虽然自2006年以来残疾女性和非残疾女性的利用率都有所提高，但利用率差距略有增加。
本研究显示了各种因素对残疾女性预防性癌症筛查服务利用率的影响。为制定针对癌症筛查测试利用不平等问题的有效举措，重要的是超越单一疾病的方法，认识到患者群体的复杂性。
