Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers.
Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers.
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DOI：
10.3389/fpubh.2021.684558
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发表时间：
2021
影响因子：
5.2
通讯作者：
Dowling L
中科院分区：
文献类型：
--
作者：
Li CC;Matthews AK;Kao YH;Lin WT;Bahhur J;Dowling L
目的：本研究旨在检验医疗可及性对不同样本中符合筛查条件的患者接受低剂量计算机断层扫描（LDCT）肺癌筛查的影响。
方法：我们采用了横断面研究设计。我们的样本包括2015年至2017年在一家大型学术医疗中心（AMC）接受肺癌筛查评估且符合2013年美国预防服务工作组（USPSTF）LDCT筛查资格指南的患者。LDCT筛查是否完成是主要的因变量。自变量是医疗可及性（保险类型、是否居住在AMC服务区内）。我们利用二元逻辑回归分析，在调整人口统计学因素（年龄、性别、种族）和吸烟史（当前吸烟状况、吸烟包 - 年史）后，检验医疗可及性对筛查完成情况的影响。
结果：共有1355人符合LDCT资格标准，其中29.8%（n = 404）完成了筛查。回归分析结果显示，拥有医疗补助保险的个体（比值比，1.51；95%置信区间，1.03 - 2.22）、居住在AMC服务区内的个体（比值比，1.71；95%置信区间，1.21 - 2.40）以及年龄在65 - 74岁的个体（比值比，1.49；95%置信区间，1.12 - 1.98）接受LDCT肺癌筛查的几率更高。筛查几率较低与拥有医疗保险（比值比，0.30；95%置信区间，0.22 - 0.41）和自费（比值比，0.27；95%置信区间，0.15 - 0.47）有关。
结论：医疗可及性与较低的筛查率独立相关。研究结果与先前确定医疗可及性因素对癌症早期检测筛查行为的接受度的重要性的研究一致。
Objective: The purpose of this study was to examine the influence of access to care on the uptake of low-dose computed tomography (LDCT) lung cancer screening among a diverse sample of screening-eligible patients. Methods: We utilized a cross-sectional study design. Our sample included patients evaluated for lung cancer screening at a large academic medical center (AMC) between 2015 and 2017 who met 2013 USPSTF guidelines for LDCT screening eligibility. The completion of LDCT screening (yes, no) was the primary dependent variable. The independent variable was access to care (insurance type, living within the AMC service area). We utilized binary logistic regression analyses to examine the influence of access to care on screening completion after adjusting for demographic factors (age, sex, race) and smoking history (current smoking status, smoking pack-year history). Results: A total of 1,355 individuals met LDCT eligibility criteria, and of those, 29.8% (n = 404) completed screening. Regression analysis results showed individuals with Medicaid insurance (OR, 1.51; 95% CI, 1.03-2.22), individuals living within the AMC service area (OR, 1.71; 95% CI, 1.21–2.40), and those aged 65–74 years (OR, 1.49; 95% CI, 1.12–1.98) had higher odds of receiving LDCT lung cancer screening. Lower odds of screening were associated with having Medicare insurance (OR, 0.30; 95% CI, 0.22–0.41) and out-of-pocket (OR, 0.27; 95% CI, 0.15–0.47). Conclusion: Access to care was independently associated with lowered screening rates. Study results are consistent with prior research identifying the importance of access factors on uptake of cancer early detection screening behaviors.
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影响因子：
4.4
作者：
Gram, Mie Agermose;Therkildsen, Christina;Tybjerg, Anne Julie
通讯作者：
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影响因子：
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作者：
ANDERSEN, RM
通讯作者：
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