Agrawal Siddarth, Gołębiowska Justyna, Makuch Sebastian, Mazur Grzegorz
Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland.
Department of Cancer Prevention and Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland.
J Clin Med. 2021 May 12;10(10):2084. doi: 10.3390/jcm10102084.
Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.
对科学证据的系统评价已经确定了预防或改善疾病以及降低死亡率的临床服务。本研究旨在评估在公共资助的医疗环境中所有推荐的循证预防服务的普及率。我们对1000名波兰成年人进行了一项基于人群的全国性横断面计算机辅助电话调查（应答率为42%）。评估了所有推荐的临床预防服务的自我报告使用情况，包括乳房X光检查、结肠镜检查、血糖筛查、疫苗接种、血压筛查和预防性咨询。结果显示，只有6.4%的成年人接受了所有推荐的预防性筛查，而只有4.3%的人接受了适当的咨询。全科医生（GP）就诊、血压筛查、血糖筛查和宫颈涂片检查是最常提供的干预措施，而流感疫苗接种、PSA评估和预防性咨询是最不普遍的服务。尽管预防性干预措施的接受率较低，但超过75%的人对使用远程医疗平台和电子咨询远程获取预防性服务感兴趣。我们的研究结果表明，在接受预防性干预方面存在重大差距。进一步的改进不仅需要改变医疗服务提供者的激励系统，还需要系统层面的创新，如远程医疗解决方案，以远程提供预防性服务并让个人参与监测过程。
