Chuang Emmeline, Pourat Nadereh, Chen Xiao, Lee Christopher, Zhou Weihao, Daniel Marlon, Hoang Hank, Sripipatana Alek
J Health Care Poor Underserved. 2019;30(1):161-181. doi: 10.1353/hpu.2019.0014.
Community health centers provide care to underserved populations least likely to adhere to cancer screening guidelines, but vary in their ability to ensure eligible patients are identified and screened. This study examines organizational factors associated with cervical and colorectal cancer screening rates among health centers funded by the Health Resources and Services Administration (HRSA).
Data were drawn from the 2015 Uniform Data System and analyzed using negative binomial regression.
On average, 53% of eligible health center patients were screened for cervical cancer and 37% for colorectal cancer. Organizational characteristics positively associated with cancer screening rates include provider-patient staffing ratios, electronic health record status, percentage revenue from public capitated managed care, and local primary care provider availability. Percentage of homeless patients was negatively associated with screening.
Efforts to improve cancer screening among underserved populations should address organizational factors that may contribute to disparities in screening uptake.
社区卫生中心为最不可能遵守癌症筛查指南的服务不足人群提供护理,但在确保识别和筛查符合条件的患者的能力方面存在差异。本研究考察了由卫生资源与服务管理局(HRSA)资助的卫生中心中与宫颈癌和结直肠癌筛查率相关的组织因素。
数据取自2015年统一数据系统,并使用负二项回归进行分析。
平均而言,符合条件的卫生中心患者中,53%接受了宫颈癌筛查,37%接受了结直肠癌筛查。与癌症筛查率呈正相关的组织特征包括医患人员配备比例、电子健康记录状态、来自公共定额管理式医疗的收入百分比以及当地初级保健提供者的可及性。无家可归患者的百分比与筛查呈负相关。
改善服务不足人群癌症筛查的努力应解决可能导致筛查接受率差异的组织因素。