Sox C H, Dietrich A J, Tosteson T D, Winchell C W, Labaree C E
Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA.
Arch Fam Med. 1997 May-Jun;6(3):223-30. doi: 10.1001/archfami.6.3.223.
To learn about cancer prevention services in primary care practices and to understand physician factors that affect the provision of these services.
Survey of physicians and their patients in 1992.
Cooperating physicians (n = 72) of a random selection of community general internist and family physician practices in New Hampshire and Vermont.
Patients (n = 2775) of the study physicians for at least 1 year, aged 42 years or older, with no life-threatening threatening illness, who recently visited the physician.
Proportion of sample patients per practice provided age- and sex-appropriate cancer prevention services in the previous year.
In this primary care population, a high proportion of patients received appropriate services in 1992. A periodic health examination within the past year was an important predictor for the receipt of many cancer prevention services. Female physicians provided more periodic health examinations than male physicians; internists provided more than family physicians.
The strongest determinant of receiving preventive services is having a periodic health examination. If clinicians and policymakers decrease emphasis on the periodic health examination as a major opportunity to provide indicated preventive services, they should ensure that a satisfactory alternative strategy is in place.
了解基层医疗实践中的癌症预防服务,并了解影响这些服务提供的医生因素。
1992年对医生及其患者进行的调查。
新罕布什尔州和佛蒙特州随机选取的社区普通内科医生和家庭医生诊所的合作医生(n = 72)。
研究医生的患者(n = 2775),年龄在42岁及以上,患有非危及生命的疾病,且最近看过医生,病程至少1年。
每个诊所样本患者在前一年接受适合其年龄和性别的癌症预防服务的比例。
在这个基层医疗人群中,1992年有很大比例的患者接受了适当的服务。过去一年中的定期健康检查是接受许多癌症预防服务的重要预测因素。女医生提供的定期健康检查比男医生多;内科医生提供的比家庭医生多。
接受预防服务的最有力决定因素是进行定期健康检查。如果临床医生和政策制定者减少对定期健康检查作为提供指定预防服务主要机会的重视,他们应确保有一个令人满意的替代策略。