Comparing Rural and Urban Cervical and Breast Cancer Screening Rates in a Privately Insured Population
Comparing Rural and Urban Cervical and Breast Cancer Screening Rates in a Privately Insured Population
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DOI：
10.1080/19371918.2017.1289872
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发表时间：
2017-01-01
影响因子：
2.5
通讯作者：
De Sa, Jeanne
中科院分区：
文献类型：
--
作者：
Orwat, John;Caputo, Nadine;De Sa, Jeanne
预防性筛查水平低因地区而异，导致乳腺癌和宫颈癌的预后不良。以前关于预防性筛查的城市和农村比较研究集中在政府项目上。这项研究量化并比较了农村和城市有私人保险的妇女的预防性癌症筛查率。国家质量论坛的措施被用来计算同一医院转诊区域（HRR）的农村和城市地区的妇女使用索赔数据的比率。2011年和2008年，24至69岁妇女的乳房X线检查率分别为77.1%和76.1%。与城市妇女相比，去看医生的农村妇女的乳房X光检查率低42%，高2%，相同的比例为56%。2011年，21至64岁妇女的宫颈癌筛查率为82.9%，2008年为83.5%。在接受农村医生检查的妇女中，宫颈癌筛查率较低的为55%，较高的为4%，相同的为42%。2008年至2011年，两次筛查中农村地区表现不佳的HRR都有所增加。农村和城市医生在妇女预防性筛查率方面存在适度但显著的差异，这突出表明需要采取切实可行的解决办法，增加筛查服务的使用，减少农村地区获得服务的障碍。
Low preventive screening varies by region and contributes to poor outcomes for breast and cervical cancer. Previous comparative urban and rural research on preventive screening has focused on government programs. This study quantified and compared rural and urban preventive cancer screening rates for women who were privately insured. National Quality Forum measures were used to calculate rates for women within rural and urban parts of the same Hospital Referral Region (HRR) using claims data. Mammography screening rates for women age 24 to 69 years were 77.1% in 2011 and 76.1% in 2008. Compared to urban women, mammography screening rates for women visiting rural physicians were lower in 42%, higher in 2% and identical in 56% of HRRs. Cervical cancer screening rates for women age 21 to 64 years were 82.9% in 2011 and 83.5% in 2008. Cervical cancer screening rates among women who saw rural physicians were lower in 55%, higher in 4%, and identical in 42% of HRRs. HRRs where rural areas underperformed urban areas increased between 2008 and 2011 for both screenings. Moderate but notable differences in women's preventive screening rates between rural and urban physicians highlight the need for practical solutions that increase use of screening services and reduce barriers to services in rural areas.