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评估联邦合格健康中心的结直肠癌筛查。

Evaluation of Colorectal Cancer Screening in Federally Qualified Health Centers.

机构信息

American Cancer Society, Statistics and Evaluation Center, Intramural Research, Atlanta, Georgia.

American Cancer Society, Statistics and Evaluation Center, Intramural Research, Atlanta, Georgia.

出版信息

Am J Prev Med. 2018 Feb;54(2):190-196. doi: 10.1016/j.amepre.2017.10.007. Epub 2017 Nov 30.

Abstract

INTRODUCTION

Screening for colorectal cancer in average-risk adults is recommended beginning at age 50 years and continuing until age 75 years. This study was conducted to provide evidence for the effectiveness of an American Cancer Society grant program promoting colorectal cancer screening by implementing evidence-based interventions proven to increase screening rates.

METHODS

Analysis compared colorectal cancer screening rates in 77 grant-funded federally qualified health centers between 2013 and 2015 to those of a sample of 77 nonfunded federally qualified health centers selected using a genetic matching technique. The Uniform Data System from 2013 to 2015 provided data used in the analysis performed in 2016.

RESULTS

Funded grantees differed significantly from nongrantees on several indicators at baseline. Genetic matching resulted in good-quality matched samples. Both matched samples increased colorectal cancer screening rates over time. Grantees increased their colorectal cancer screening rates significantly more than nongrantees, especially between 2013 and 2014, where funded federally qualified health centers increased by 9% and nonfunded federally qualified health centers increased by 3%. Across the 3 years, increases were 12% and 9%, respectively.

CONCLUSIONS

The findings suggest grant funding was effective in promoting improvements in colorectal cancer screening rates in funded federally qualified health centers, and these improvements exceed those of nonfunded federally qualified health centers. Funding that results in targeted, intensive efforts supported by technical assistance and accountability for data and reporting, can result in improved system policies and practices that, in turn, can increase screening rates among uninsured and underserved populations.

摘要

简介

建议在 50 岁时开始对一般风险的成年人进行结直肠癌筛查,并持续至 75 岁。本研究旨在提供美国癌症协会资助项目促进结直肠癌筛查的有效性证据,该项目通过实施已证明可提高筛查率的循证干预措施来实现这一目标。

方法

分析比较了 2013 年至 2015 年期间 77 家获得美国癌症协会资助的联邦合格健康中心与通过遗传匹配技术选择的 77 家非资助联邦合格健康中心的结直肠癌筛查率。2013 年至 2015 年的统一数据系统提供了用于 2016 年进行分析的数据。

结果

在基线时,受资助的受赠人与非受赠人在几个指标上存在显著差异。遗传匹配产生了高质量的匹配样本。两个匹配样本的结直肠癌筛查率都随时间增加。与非受赠者相比,受赠者的结直肠癌筛查率显著增加,特别是在 2013 年至 2014 年期间,受资助的联邦合格健康中心增加了 9%,而非受资助的联邦合格健康中心增加了 3%。在这 3 年中,增幅分别为 12%和 9%。

结论

这些发现表明,资助在促进受资助的联邦合格健康中心结直肠癌筛查率的提高方面是有效的,而且这些提高超过了非受资助的联邦合格健康中心。资助导致了有针对性的、密集的努力,得到技术援助和数据报告问责制的支持,从而可以改善系统政策和实践,进而提高未保险和服务不足人群的筛查率。

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