Using colorectal trends in the U.S. to identify unmet primary care needs of vulnerable populations.
Using colorectal trends in the U.S. to identify unmet primary care needs of vulnerable populations.
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利用美国的结直肠趋势来确定弱势群体未得到满足的初级保健需求。
DOI：
10.1016/j.ypmed.2012.05.016
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发表时间：
2012
影响因子：
5.1
通讯作者：
Gonzalez,HectorM
中科院分区：
文献类型：
--
作者：
Miranda,PatriciaY;Johnson-Jennings,Michelle;Tarraf,Wassim;Gonzalez,Patricia;Vega,WilliamA;Gonzalez,HectorM
近年来，结直肠癌筛查（CRC）的差异越来越大。目的探讨在少数民族/种族人群（包括拉丁裔人群）中实现2010年健康人目标的进展情况。方法多变量logistic回归分析了种族/种族与自我报告的指南一致性CRC筛查的主要结果之间的关系，考虑了2000年至2007年医疗支出小组调查中65,947名50岁及以上的受访者的时间趋势（非拉丁裔白人、非拉丁裔黑人、波多黎各人、古巴人、墨西哥人和其他拉丁裔）。我们还测试了教育、收入和健康保险的修正效应。结果大多数人群都达到了2010年健康人CRC筛查率目标，包括非拉丁裔白人（47%）、非拉丁裔黑人（42%）和波多黎各人（40%），而墨西哥人的筛查率则有所降低（28%）。高等教育、收入和保险覆盖率部分地减弱了这种低可能性，但墨西哥人在过去5年中接受内窥镜检查的比率仍然显著低于非拉丁裔白人(OR(95% CI)=0.68(0.59-0.77)}和接受过任何CRC筛查的比率{0.70(0.62-0.79)}。结论在所调查的族裔/种族群体中，只有墨西哥人符合CRC筛查的医疗差异标准。研究结果表明，如果能够获得影响护理连续性的资源或支付预防服务的能力，并且充分确定目标人群，则可以实现医疗保健公平目标。
BACKGROUNDColorectal cancer screening (CRC) disparities have worsened in recent years.OBJECTIVETo examine progress toward Healthy People 2010 goals for CRC screening among ethnic/racial groups, including disaggregated Latino groups.METHODSMultivariate logistic regressions examined associations between ethnicity/race and primary outcomes of self-reported guideline-concordant CRC screenings considering time trends for 65,947 respondents of the Medical Expenditure Panel Survey from 2000 to 2007 age 50-years and older from six groups (non-Latino White, non-Latino Black, Puerto Rican, Cuban, Mexican, and Other Latino). We also tested for modification effects by education, income, and health insurance.RESULTSMost groups approached Healthy People 2010 CRC screening rate goals, including non-Latino Whites (47%), non-Latino Blacks (42%) and Puerto Ricans (40%), while Mexicans remained disparately lower (28%). Higher education, income and insurance coverage, partially attenuated this lower likelihood, but Mexican rates remained significantly lower than non-Latino Whites for receiving endoscopy in the past 5years {OR(95% CI)=0.68(0.59–0.77)} and having received any CRC screening {0.70(0.62–0.79)}.CONCLUSIONSAmong ethnic/racial groups examined, only Mexicans met healthcare disparity criteria in CRC screening. Findings suggest that healthcare equity goals can be attained if resources affecting continuity of care or ability to pay for preventive services are available, and targeted populations are adequately identified.
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影响因子：
5.5
作者：
Bustamante, Arturo Vargas;Chen, Jie;Ortega, Alexander N.
通讯作者：
Ortega, Alexander N.
DOI：
--
发表时间：
1991
期刊：
Ca
影响因子：
--
作者：
C. Mettlin;G. Dodd
通讯作者：
G. Dodd
DOI：
10.1056/nejmoa1100370
发表时间：
2012-02-23
期刊：
The New England journal of medicine
影响因子：
--
作者：
Zauber AG;Winawer SJ;O'Brien MJ;Lansdorp-Vogelaar I;van Ballegooijen M;Hankey BF;Shi W;Bond JH;Schapiro M;Panish JF;Stewart ET;Waye JD
通讯作者：
Waye JD
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM
影响因子：
5.1
作者：
Gorin, SS;Heck, JE
通讯作者：
Heck, JE