The role of facility and patient mix factors on recovery of screening and diagnostic mammography volumes following the initial COVID-19 pandemic wave.
The role of facility and patient mix factors on recovery of screening and diagnostic mammography volumes following the initial COVID-19 pandemic wave.
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DOI：
10.1002/cam4.5793
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发表时间：
2023-05
期刊：
影响因子：
4
通讯作者：
Murphy, Anne Marie
中科院分区：
文献类型：
--
作者：
Lomahan, Sarah;Rauscher, Garth H.;Murphy, Anne Marie
本研究的目的是了解乳腺X射线摄影设施能够将每月筛查和诊断乳腺X射线摄影量恢复到大流行前水平的程度，并确定与恢复相关的设施和患者组合因素。位于伊利诺伊州库克县及其附近的设施符合条件。总共有58家筛查机构和30家诊断性乳房X光检查机构按月提交了乳房X光检查卷，并按筛查卷交叉列出了患者邮政编码。将大流行后6个月（2020年7月至12月）和随后的大流行后期间（2021年1月至6月）的每月筛查和诊断量与2019年同期进行了比较。邮政编码分布用于定义与劣势相关的患者组合特征。与大流行前相比，乳腺成像卓越中心每月进行的筛查性乳房X光检查减少了大约50次（95% CI：-91，-9），但在大流行后不久，平均多进行了50次诊断性乳房X光检查（95% CI：24，82）。服务于主要是黑人人口的设施每月进行的筛查减少了大约50次（95% CI：-93，-13），而每月的诊断没有任何增加。高度认可的（通常是较高的诊断量）设施似乎积极分流诊断，而资源较低的设施似乎难以恢复到大流行前的诊断量，而没有分流诊断。大流行病对少数群体造成了严重影响，这些群体已经受到高质量乳房X光检查的差异获得和使用的影响。可能的解释进行了讨论。应加强政策，以促进在医疗保健系统面临压力时对服务进行分类。我们发现，资源较高的设施似乎积极分流诊断屏幕，而较低的资源设施通常无法恢复到大流行前的量，似乎没有分流诊断屏幕。此外，我们还发现，疫情对弱势群体和少数群体造成了严重影响。
The goal of this study was to understand the extent to which mammography facilities were able to recover monthly screening and diagnostic mammography volumes to their prepandemic levels and to determine what facility and patient mix factors were associated with recovery. Facilities, located in and adjacent to Cook County, Illinois, were eligible. In all, 58 screening and 30 diagnostic mammogram facilities submitted mammogram volumes by month with a cross‐listing of patient ZIP codes by screening volumes. Monthly screening and diagnostic volumes for the 6‐month immediate postpandemic period (July–December 2020) and for the subsequent postpandemic period (January–June 2021) were compared with the same months in 2019. ZIP code distributions were used to define patient mix characteristics related to disadvantage. Compared with the prepandemic period, Breast Imaging Centers of Excellence conducted roughly 50 fewer monthly screening mammograms (95% CI: −91, −9) but 50 more diagnostic mammograms (95% CI: 24, 82) on average in the immediate postpandemic period. Facilities serving a predominantly Black population conducted roughly 50 fewer monthly screens (95% CI: −93, −13) without any increase in monthly diagnostics. Highly accredited (and typically higher volume) facilities appeared to actively triage diagnostics, whereas lower resource facilities appeared to struggle to recover to prepandemic volumes without triage to diagnostics. The pandemic disproportionally impacted minority populations already affected by differential access to and utilization of high‐quality mammography. Potential explanations are discussed. Policies should be strengthened to facilitate triaging of services during times of stress to the healthcare system. We found that higher resource facilities appeared to actively triage diagnostics over screens, whereas lower resource facilities were generally not able to recover to prepandemic volumes and did not appear to triage diagnostics over screens. Additionally, we found that the pandemic disproportionally impacted disadvantaged and minority populations.
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影响因子：
4.5
作者：
Grimm, Lars J;Lee, Cindy;Rosenberg, Robert D;Burleson, Judy;Simanowith, Michael;Fruscello, Tom Jr;Pelzl, Casey E;Friedewald, Sarah M;Moy, Linda;Zuley, Margarita L
通讯作者：
Zuley, Margarita L
影响因子：
3.8
作者：
Miller MM;Meneveau MO;Rochman CM;Schroen AT;Lattimore CM;Gaspard PA;Cubbage RS;Showalter SL
通讯作者：
Showalter SL
影响因子：
19.7
作者：
Cavallo, Joseph J.;Forman, Howard P.
通讯作者：
Forman, Howard P.
影响因子：
1.7
作者：
Flores, Andrea;Gayle, George-Levi
通讯作者：
Gayle, George-Levi
DOI：
10.3390/healthcare10020364
发表时间：
2022-02-13
期刊：
Healthcare (Basel, Switzerland)
影响因子：
--
作者：
Lluch C;Galiana L;Doménech P;Sansó N
通讯作者：
Sansó N