US clinicians' perspectives on less frequent routine gynecologic examinations
US clinicians' perspectives on less frequent routine gynecologic examinations
复制标题
DOI：
10.1016/j.ypmed.2014.02.004
复制
发表时间：
2014-05-01
影响因子：
5.1
通讯作者：
Sawaya, George F.
中科院分区：
文献类型：
--
作者：
Henderson, Jillian T.;Yu, Jean M.;Sawaya, George F.
Objective.随着宫颈癌筛查频率降低的新建议，常规妇科检查之间的间隔时间也可能会被考虑。在2010-11年对美国妇产科医生进行了一项具有全国代表性的邮寄调查（n = 521，应答率62%）。临床医生被问及他们对年度妇科检查的看法，以及对无症状患者将检查间隔从每年一次延长至每3年一次的后果。结果。超过三分之二的人认为每年的妇科检查对育龄妇女非常重要（69%）;较少的人认为对更年期妇女非常重要（55%）。大多数人预计，将检查改为每3年一次将导致患者满意度降低（78%），避孕措施（74%）以及患者健康和福祉（74%）。预计诊所数量（93%）和财务报销（78%）也会下降。较长间隔的预期效果因供应商特征、地理位置和实践设置而异。美国的妇产科医生认为，常规检查之间的较长时间间隔会对患者和医疗实践产生负面影响，但地区，实践和个人特征存在差异。将每年的妇科检查重新定义为避孕咨询和健康维护检查，可以解决财务和患者数量问题，患者和其他提供者的观点可能会揭示减少妇科检查频率的可能益处。(C)2014爱思唯尔公司All rights reserved.
Objective. With newer recommendations for less frequent cervical cancer screening, longer intervals between routine gynecologic examinations might also be considered.Methods. A nationally representative mailed survey of U.S. obstetrician-gynecologists (n = 521, response rate 62%) was conducted in 2010-11. Clinicians were asked their views on annual gynecologic examinations and on the consequences of extending the interval from annually to every 3 years for asymptomatic patients.Results. Over two-thirds considered annual gynecologic examination very important for women in their reproductive years (69%); fewer consider it very important for women in menopause (55%). Most anticipated that shifting examinations to every 3 years would result in lower patient satisfaction (78%), contraceptive provision (74%), and patient health and well-being (74%). Decreases in clinic volume (93%) and financial reimbursement (78%) were also expected. Anticipated effects of longer intervals varied by provider characteristics, geography, and practice setting.Conclusion. Obstetrician-gynecologists in the U.S. believed that longer intervals between routine examinations would have negative repercussions for patients and medical practice, but there were differences by region, practice, and personal characteristics. Redefining annual gynecologic visits as contraceptive counseling and health maintenance visits could address financial and patient volume concerns, and perspectives from patients and other providers might reveal possible benefits of less frequent gynecologic examinations. (C) 2014 Elsevier Inc. All rights reserved.