Bindman A B, Grumbach K, Osmond D, Vranizan K, Stewart A L
Primary Care Research Center, San Francisco General Hospital, CA 94110, USA.
J Gen Intern Med. 1996 May;11(5):269-76. doi: 10.1007/BF02598266.
To examine whether health insurance, a regular place of care, and optimal primary care are independently associated with receiving preventive care services.
A cross-sectional telephone survey.
Population based.
Probability sample of 3,846 English-speaking and Spanish-speaking women between the ages of 18 and 64 in urban California.
Women were asked about their demographic characteristics, financial status, health insurance status, need for ongoing care, regular place of care, and receipt of blood pressure screening, clinical breast examinations, mammograms, and Pap smears. Women who reported a regular place of care were asked about four components of primary care: availability, continuity, comprehensiveness, and communication.
In multivariate analyses that controlled for differences in demographics, financial status, and need for ongoing care, having a regular place of care was the most important factor associated with receiving preventive care services (p < .0001). Having health insurance (p < .001) and receiving optimal primary care from the regular place of care (p < .01) further significantly increased the likelihood of receiving preventive care services.
A regular source of care is the single most important factor associated with the receipt of preventive services, but optimal primary care from a regular place increases the likelihood that women will receive preventive care.
探讨医疗保险、固定的就医场所和优质的初级保健服务是否与接受预防性保健服务独立相关。
横断面电话调查。
基于人群。
加利福尼亚州城市地区3846名年龄在18至64岁之间、讲英语和西班牙语的女性的概率样本。
询问女性的人口统计学特征、财务状况、医疗保险状况、持续护理需求、固定的就医场所,以及是否接受过血压筛查、临床乳房检查、乳房X光检查和巴氏涂片检查。对于报告有固定就医场所的女性,询问其初级保健服务的四个组成部分:可及性、连续性、全面性和沟通情况。
在控制了人口统计学、财务状况和持续护理需求差异的多变量分析中,有固定的就医场所是与接受预防性保健服务相关的最重要因素(p < .0001)。拥有医疗保险(p < .001)以及从固定就医场所接受优质的初级保健服务(p < .01)进一步显著增加了接受预防性保健服务的可能性。
固定的就医来源是与接受预防性服务相关的最重要单一因素,但从固定场所获得优质的初级保健服务会增加女性接受预防性保健的可能性。