Cancer screening in HMOs: program development and evaluation.

Cancer screening in HMOs: program development and evaluation.
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HMO 中的癌症筛查:计划开发和评估。

DOI:
10.1016/s0749-3797(97)00040-8
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发表时间:
1998
影响因子:
5.5
通讯作者:
Thompson,RS
Thompson,RS
中科院分区:
医学2区
文献类型:
--
作者:
Mandelson,MT;Thompson,RS

文献摘要

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在许多临床环境中,有效的癌症控制受到与大多数医疗实践的急性护理方向相关的障碍的阻碍。这些措施包括:根据紧急情况确定医疗问题的优先次序;以问题为导向的医疗记录,没有为癌症筛查提供持续的文件机制;冲突的指导方针;也没有办法确定和确定有资格接受筛查的人。相比之下,卫生保健组织特别适合于提供有效的癌症控制,因为它们已经建立了成功的一级和二级预防所需的许多联系。方法本文阐述了以人群为基础的癌症预防方法的原则,并借鉴了普吉特海湾卫生组织(Puget Sound)的经验。普吉特海湾卫生组织是一家位于华盛顿西部的卫生组织,在预防和集中癌症筛查方面有20多年的经验。通过对乳腺癌、前列腺癌、宫颈癌和结直肠癌的筛查,讨论了在癌症预防问题中选择和确定优先事项的方法,成功筛查项目的组成部分,以及短期和长期评估的措施。结论卫生保健组织在整合卫生服务和促进护理连续性方面发挥了领导作用。采用以人群为基础的方法,癌症预防计划可以得到现有自动化信息服务的支持,通过早期检测来降低发病率和死亡率。
IntroductionIn many clinical settings, effective cancer control is hampered by barriers related to the acute-care orientation of most medical practices. These include: prioritization of medical problems on the basis of urgency; a problem-oriented medical record that provides no ongoing documentation mechanism for cancer screening; conflicting guidelines; and no method for identifying and targeting persons who are eligible for screening. In contrast, HMOs are uniquely suited to deliver effective cancer control as they have already established many of the linkages required for successful primary and secondary prevention.MethodsThis paper describes the principles of a population-based approach to cancer prevention and draws on the experience of Group Health Cooperative of Puget Sound, an HMO in western Washington with more than 20 years’ experience in prevention and centralized cancer screening. Methods for selecting and determining priorities among cancer prevention issues, components of successful screening programs, and measures of short- and long-term evaluation are discussed through examples of screening for breast, prostate, cervix, and colorectal cancers.ConclusionsHMOs have provided leadership in the integration of health services and the promotion of continuity of care. Using a population-based approach, cancer prevention programs may be supported by existing automated information services to reduce morbidity and mortality through early detection.
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