Patient-level factors associated with receipt of preventive care in the safety net.
Patient-level factors associated with receipt of preventive care in the safety net.
复制标题
DOI：
10.1016/j.ypmed.2022.107024
复制
发表时间：
2022-05
影响因子：
5.1
通讯作者：
DeVoe, Jennifer
中科院分区：
文献类型：
--
作者：
Hatch, Brigit;Tillotson, Carrie;Hoopes, Megan;Huguet, Nathalie;Marino, Miguel;DeVoe, Jennifer
预防对优化健康至关重要，但大多数人没有得到所有建议的预防服务。随着预防性建议的复杂性增加，有必要采取新的措施来衡量一个人的最新程度，并确定个人层面的障碍和促进因素，以获得所需的预防性护理。我们使用2014-2017年期间美国（US）社区卫生中心（CHC）全国网络的电子健康记录数据，以12项预防服务的预防比率（以百分比表示的最新人次）和总预防指数来衡量患者水平的最新状态。我们使用负二项回归来确定与最新预防保健相关的因素。我们评估了165个初级保健诊所的267，767名患者。平均预防率范围从丙型肝炎筛查的8.7%到血压筛查的83.3%。平均综合预防指数为43%。缺乏健康保险、吸烟和无家可归与大多数癌症和心血管筛查的预防率较低相关（p<0.05）。有更多的门诊就诊，更好的护理连续性，以及在患者门户网站上注册与总预防指数（p<0.05）和除衣原体和HIV筛查外的所有服务的较高预防率（p<0.05）呈正相关。总体而言，预防服务的接受率很低。CHC患者在接受所需的预防性护理方面遇到了许多障碍，但某些医疗保健行为-定期就诊，通常的提供者连续性和患者门户网站注册-始终与最新的预防性护理相关。这些协会应告知未来的努力，以改善预防保健的提供。
Prevention is critical to optimizing health, yet most people do not receive all recommended preventive services. As the complexity of preventive recommendations increases, there is a need for new measurements to capture the degree to which a person is up to date, and identify individual-level barriers and facilitators to receiving needed preventive care. We used electronic health record data from a national network of community health centers (CHCs) in the United States (US) during 2014–2017 to measure patient-level up-to-date status with preventive ratios (measuring up-to-date person-time denoted as a percent) for 12 preventive services and an aggregate preventive index. We use negative binomial regression to identify factors associated with up-to-date preventive care. We assessed 267,767 patients across 165 primary care clinics. Mean preventive ratios ranged from 8.7% for Hepatitis C screening to 83.3% for blood pressure screening. The mean aggregate preventive index was 43%. Lack of health insurance, smoking, and homelessness were associated with lower preventive ratios for most cancer and cardiovascular screenings (p<0.05). Having more ambulatory visits, better continuity of care, and enrollment in the patient portal were positively associated with the aggregate preventive index (p<0.05) and higher preventive ratios for all services (p<0.05) except chlamydia and HIV screening. Overall, receipt of preventive services was low. CHC patients experience many barriers to receiving needed preventive care, but certain healthcare behaviors – regular visits, usual provider continuity, and patient portal enrollment – were consistently associated with more up-to-date preventive care. These associations should inform future efforts to improve preventive care delivery.
登录
查看更多内容
影响因子：
12.7
作者：
DeVoe, JE;Fryer, GE;Green, L
通讯作者：
Green, L
DOI：
10.1136/amiajnl-2013-002333
发表时间：
2014-07-01
影响因子：
6.4
作者：
Heintzman, John;Bailey, Steffani R.;DeVoe, Jennifer E.
通讯作者：
DeVoe, Jennifer E.
DOI：
10.1197/jamia.m2555
发表时间：
2008-05-01
影响因子：
6.4
作者：
Dexheimer, Judith W.;Talbot, Thomas R.;Aronsky, Dominik
通讯作者：
Aronsky, Dominik
DOI：
10.3122/jabfm.2012.05.120141
发表时间：
2012-09
期刊：
Journal of the American Board of Family Medicine : JABFM
影响因子：
--
作者：
DeVoe JE;Likumahuwa S;Eiff MP;Nelson CA;Carroll JE;Hill CN;Gold R;Kullberg PA
通讯作者：
Kullberg PA
影响因子：
9.7
作者：
Borsky, Amanda;Zhan, Chunliu;Meyers, David
通讯作者：
Meyers, David