Kim Karen E, Tangka Florence K L, Jayaprakash Manasi, Randal Fornessa T, Lam Helen, Freedman David, Carrier Laurie A, Sargant Coletta, Maene Chieko, Hoover Sonja, Joseph Djenaba, French Cynthia, Subramanian Sujha
University of Chicago, Chicago, IL, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Health Promot Pract. 2020 Nov;21(6):884-890. doi: 10.1177/1524839920954162. Epub 2020 Sep 29.
With funding from the Centers for Disease Control and Prevention's Colorectal Cancer Control Program, The University of Chicago Center for Asian Health Equity partnered with a federally qualified health center (FQHC) to implement multiple evidence-based interventions (EBIs) in order to improve colorectal cancer (CRC) screening uptake. The purpose of this study is to determine the effectiveness and cost of implementing a provider reminder system entered manually and supplemented with patient reminders and provider assessment and feedback. The FQHC collected demographic characteristics of the FQHC and outcome data from January 2015 through December 2015 (preimplementation period) and cost from January 2016 through September 2017 (implementation period). Cost data were collected for the implementation period. We report on the demographics of the eligible population, CRC screening order, completion rates by sociodemographic characteristics, and, overall, the effectiveness and cost of implementation. From the preimplementation phase to the implementation phase, there was a 21.2 percentage point increase in CRC screens completed. The total cost of implementing EBIs was $40908.97. We estimated that an additional 283 screens were completed because of the interventions, and the implementation cost of the interventions was $144.65 per additional screen. With the interventions, CRC screening uptake in Chicago increased for all race/ethnicity and demographic backgrounds at the FQHC, particularly for patients aged 50 to 64 years and for Asian, Hispanic, and uninsured patients.
在疾病控制与预防中心结直肠癌控制项目的资助下，芝加哥大学亚洲健康公平中心与一家联邦合格健康中心（FQHC）合作，实施多项循证干预措施（EBI），以提高结直肠癌（CRC）筛查的接受率。本研究的目的是确定实施手动输入并辅以患者提醒以及提供者评估和反馈的提供者提醒系统的有效性和成本。FQHC收集了2015年1月至2015年12月（实施前期）的FQHC人口统计学特征和结果数据，以及2016年1月至2017年9月（实施期）的成本数据。收集了实施期的成本数据。我们报告了符合条件人群的人口统计学特征、CRC筛查顺序、按社会人口统计学特征划分的完成率，以及总体实施的有效性和成本。从实施前期到实施期，完成的CRC筛查增加了21.2个百分点。实施EBI的总成本为40908.97美元。我们估计，由于这些干预措施，额外完成了283次筛查，干预措施的实施成本为每次额外筛查144.65美元。通过这些干预措施，FQHC所有种族/族裔和人口背景的芝加哥居民的CRC筛查接受率都有所提高，尤其是50至64岁的患者以及亚洲、西班牙裔和未参保患者。
