Determinants of Abnormal Cervical Cancer Screening Follow-Up And Invasive Cervical Cancer Among Uninsured and Underinsured Women in New Jersey
Determinants of Abnormal Cervical Cancer Screening Follow-Up And Invasive Cervical Cancer Among Uninsured and Underinsured Women in New Jersey
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DOI：
10.1353/hpu.2019.0050
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发表时间：
2019-05-01
影响因子：
1.4
通讯作者：
Stroup, Antoinette
中科院分区：
文献类型：
--
作者：
Tsui, Jennifer;Llanos, Adana A. M.;Stroup, Antoinette
目标.确定在接受宫颈癌筛查的未投保/投保不足妇女中进行浸润性宫颈癌后续护理和诊断的决定因素。方法.我们研究了卫生保健设施，地区水平和个人水平的因素之间的关联，对来自新泽西癌症教育和早期检测计划（2000-2015）的回顾性队列妇女的结果感兴趣。结果在卫生部诊所（aOR：3.11，95%CI：2.30-4.20）和卫生保健系统附属诊所（aOR：1.71，95%CI：1.11-2.64）筛查的妇女与私人医生诊所的妇女相比，缺乏随访护理的几率更高。同样，居住在失业率最高地区的妇女缺乏后续行动的几率更高（aOR：1.48，95% CI：1.07-2.06）。与美国相比，出生在中美洲/南美洲国家的妇女的后续护理延迟率更高。出生女性（aOR：1.46，95%CI：1.12-1.92）。结论.需要加强外联工作和多层次战略，以消除长期存在的障碍，为得不到充分服务的妇女提供适当的后续护理。
Objectives. To identify determinants of follow-up care and diagnosis of invasive cervical cancer among uninsured/underinsured women screened for cervical cancer. Methods. We examined the associations between health care facility, area-level, and individual-level factors on the outcomes of interest in retrospective cohort of women from the New Jersey Cancer Education and Early Detection Program (2000-2015). Results. Women screened at department of health clinics (aOR:3.11, 95% CI: 2.30-4.20) and health care system-affiliated clinics (aOR: 1.71, 95% CI: 1.11-2.64) had higher odds of lacking follow-up care compared with women in private physician practices. Similarly, women residing in areas with the highest unemployment had higher odds of lacking follow-up (aOR: 1.48, 95% CI: 1.07-2.06). Delays in follow-up care were higher for women born in Central/South American countries compared with U.S.-born women (aOR: 1.46, 95% CI: 1.12-1.92). Conclusions. Improved outreach efforts and multilevel strategies are needed to address the persistent barriers to appropriate follow-up care for underserved women.