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肺癌筛查中患者与医疗服务提供者的讨论:我们目前的状况如何以及相关因素有哪些?

Lung cancer screening patient-provider discussion: Where do we stand and what are the associated factors?

作者信息

Chalian Hamid, Khoshpouri Pegah, Iranmanesh Arya M, Mammarappallil Joseph G, Assari Shervin

机构信息

Department of Radiology, Duke University Medical Center, Durham, NC, USA.

Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

SAGE Open Med. 2019 May 26;7:2050312119854265. doi: 10.1177/2050312119854265. eCollection 2019.

Abstract

OBJECTIVE

The primary objective of this study was to estimate the percentage of individuals possibly eligible for lung cancer screening that report having discussed screening with a health care provider. The secondary objective was to investigate the associated factors of having patient-provider lung cancer screening discussion.

METHODS

Data from the Health Information National Trends Survey 2017 were used ( = 3217). Lung cancer screening eligibility was based on the criteria utilized by the Centers for Medicare and Medicaid Services. Gender, race, educational attainment, health insurance coverage, and usual source of health care were covariates. Current or former smokers ages 55-77 ( = 706) were considered potentially eligible for lung cancer screening (dependent variable).

RESULTS

Only 12.24% of individuals potentially eligible for lung cancer screening report prior discussion regarding lung cancer screening with a health care provider. Being eligible for lung cancer screening based on Centers for Medicare and Medicaid Services eligibility criteria was positively associated with the odds of a patient-provider lung cancer screening discussion (odds ratio = 3.95, 95% confidence interval = 2.48-6.30). Unlike gender, race, education, or insurance coverage, a usual source of health care was positively associated with a patient-provider screening discussion (odds ratio = 2.48, 95% confidence interval = 1.31-4.70).

CONCLUSION

Individuals potentially eligible for lung cancer screening are more likely to have screening discussions with a health care provider. Having a usual source of health care may increase the odds of such a discussion, while patients are not discriminated based on race, gender, education, and insurance coverage. However, the relatively low rate (12.24%) of reported patient-provider lung cancer screening discussion indicates that significant barriers still remain.

摘要

目的

本研究的主要目的是估计可能符合肺癌筛查条件且报告曾与医疗服务提供者讨论过筛查的个体百分比。次要目的是调查患者与医疗服务提供者进行肺癌筛查讨论的相关因素。

方法

使用了2017年美国国家健康信息趋势调查的数据(n = 3217)。肺癌筛查 eligibility基于医疗保险和医疗补助服务中心使用的标准。性别、种族、教育程度、医疗保险覆盖范围和通常的医疗保健来源为协变量。年龄在55 - 77岁的当前或 former吸烟者(n = 706)被认为可能符合肺癌筛查条件(因变量)。

结果

在可能符合肺癌筛查条件的个体中,只有12.24%报告曾与医疗服务提供者就肺癌筛查进行过 prior讨论。根据医疗保险和医疗补助服务中心的eligibility标准符合肺癌筛查条件与患者与医疗服务提供者进行肺癌筛查讨论的几率呈正相关(优势比 = 3.95,95%置信区间 = 2.48 - 6.30)。与性别、种族、教育程度或保险覆盖范围不同,通常的医疗保健来源与患者与医疗服务提供者的筛查讨论呈正相关(优势比 = 2.48,95%置信区间 = 1.31 - 4.70)。

结论

可能符合肺癌筛查条件的个体更有可能与医疗服务提供者进行筛查讨论。有通常的医疗保健来源可能会增加进行此类讨论的几率,同时患者不会因种族、性别、教育程度和保险覆盖范围而受到歧视。然而,报告的患者与医疗服务提供者进行肺癌筛查讨论的相对较低比例(12.24%)表明仍然存在重大障碍。

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