Patterns of use of mammography among inner-city Detroit women: contrasts between a health department, HMO, and private hospital.
Patterns of use of mammography among inner-city Detroit women: contrasts between a health department, HMO, and private hospital.
复制标题
底特律市中心妇女使用乳房 X 光检查的模式：卫生部门、HMO 和私立医院之间的对比。
DOI：
10.1097/00005650-199304000-00004
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发表时间：
1993
期刊：
影响因子：
3
通讯作者：
Moncrease,A
中科院分区：
文献类型：
--
作者：
Burack,RC;Gimotty,PA;Stengle,W;Warbasse,L;Moncrease,A
这项研究评估了2880名40岁或40岁以上的市内少数民族妇女的乳房X光照相使用模式，她们在1988或1989年间在由卫生部门(两个地点)、卫生维护组织(HMO)和私人医院运营的四个实习点接受了持续的初级保健服务。23%到32%的年龄合格女性可以记录乳房X光检查转诊，15%到26%的女性完成乳房X光检查。在没有做过乳房X光检查的女性中，85%的人从未被转介过，而15%的人被转介但无法完成检查。在多元Logistic回归分析中，与乳房X光检查相关的因素包括年龄小于70岁、乳腺癌危险因素的存在以及更频繁的临床就诊。在卫生保健组织和医院诊所进行乳房X光检查的频率比在卫生部门更高，但这种关系与妇女以前的就诊和乳房X光检查经历不同。在为未参保妇女提供服务的地点，乳房X光检查的使用与是否有医疗保险无关。结论是，在所研究的三个不同的卫生保健组织中，乳房X光检查的未充分利用是早期发现乳腺癌的主要障碍，改善乳腺癌控制的干预措施应侧重于促进医生转诊实践。
This study assessed the pattern of utilization of mammography among 2,880 inner-city minority women 40 years of age or older who received ongoing primary care services during 1988 or 1989 at four practice sites operated by a health department (two sites), Health Maintenance Organization (HMO), and private hospital. Mammography referral could be documented for 23% to 32% of age eligible women and completed mammograms for 15% to 26%. Among women without a mammogram, 85% had never been referred while 15% were referred but unable to complete the procedure. In multiple logistic regression analysis, factors associated with mammography include age less than 70 years, presence of a breast cancer risk factor and more frequent clinic visits. Mammography was somewhat more frequent at the HMO and hospital clinic than at the health department, but this relationship varied with the women's previous visit and mammography experience. At sites serving uninsured women, mammography use was not associated with the presence or absence of health insurance. It is concluded that the underutilization of mammography is a substantial barrier to the early detection of breast cancer in each of the three different health care organizations studied, and that interventions to improve breast cancer control should focus upon facilitating physician referral practices.