马里兰州医疗补助行为健康家庭计划与严重精神疾病患者癌症筛查的关联。
Association Between the Maryland Medicaid Behavioral Health Home Program and Cancer Screening in People With Serious Mental Illness.
机构信息
Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore (Murphy, Daumit, Stone, Pollack); Department of Mental Health (Daumit, Stuart, McGinty), Department of Health Policy and Management (Daumit, Bandara, Kennedy-Hendricks, Stuart, Pollack, McGinty), and Center for Mental Health and Addiction Policy Research (Bandara, Kennedy-Hendricks, Stuart, McGinty), Johns Hopkins Bloomberg School of Public Health, Baltimore.
出版信息
Psychiatr Serv. 2020 Jun 1;71(6):608-611. doi: 10.1176/appi.ps.201900299. Epub 2020 Feb 5.
OBJECTIVE
This study evaluated the association of the Maryland Medicaid behavioral health home (BHH) integrated care program with cancer screening.
METHODS
Using administrative claims data from October 2012 to September 2016, the authors measured cancer screening among 12,176 adults in Maryland's psychiatric rehabilitation program who were eligible for cervical (N=6,811), breast (N=1,658), and colorectal (N=3,430) cancer screening. Marginal structural modeling was used to examine the association between receipt of annual cancer screening and whether participants had ever enrolled in a BHH (enrolled: N=3,298, 27%; not enrolled: N=8,878, 73%).
RESULTS
Relative to nonenrollment, BHH enrollment was associated with increased screening for cervical and breast cancer but not for colorectal cancer. Predicted annual rates remained low, even in BHHs.
CONCLUSIONS
Despite estimates of improvements in cervical and breast cancer screening after BHH implementation, cancer screening rates remained suboptimal. Broader cancer screening interventions are needed to improve cancer screening for people with mental illness.
目的
本研究评估了马里兰州医疗补助行为健康之家（BHH）综合护理计划与癌症筛查之间的关联。
方法
利用 2012 年 10 月至 2016 年 9 月的行政索赔数据，作者对马里兰州精神康复计划中符合宫颈癌（N=6811）、乳腺癌（N=1658）和结直肠癌（N=3430）筛查条件的 12176 名成年人进行了癌症筛查。使用边缘结构模型来检验是否接受年度癌症筛查与参与者是否参加 BHH 之间的关系（参加：N=3298，27%；未参加：N=8878，73%）。
结果
与未参加相比，BHH 参加与宫颈癌和乳腺癌筛查的增加有关，但与结直肠癌筛查无关。即使在 BHH 中，预测的年度筛查率仍然较低。
结论
尽管 BHH 实施后估计宫颈癌和乳腺癌筛查有所改善，但癌症筛查率仍不理想。需要更广泛的癌症筛查干预措施来提高精神疾病患者的癌症筛查率。
Zotero 插件