Geographical Variation in Surveillance Strategies After Curative-Intent Surgery for Upper Aerodigestive Tract Cancer
Geographical Variation in Surveillance Strategies After Curative-Intent Surgery for Upper Aerodigestive Tract Cancer
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上呼吸消化道癌根治性手术后监测策略的地理差异
DOI：
10.1245/aso.2006.04.014
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发表时间：
2006
影响因子：
3.7
通讯作者：
Katherine S. Virgo
中科院分区：
文献类型：
--
作者：
F. Johnson;Michael H. Johnson;M. Clemente;R. Paniello;Katherine S. Virgo
背景分析医疗资源利用的地理差异通常用于确定过度利用或利用不足的地区。方法：我们调查了美国头颈协会的会员，了解他们对上呼吸道癌症患者在接受可能治愈的治疗后推荐的就诊频率、13项影像学检查和血液检查。结果在接受调查的1322名成员中，610名（46%）回复，420名（32%）回复是可评估的。调查结果以美国人口普查区、大都会统计区和管理式医疗机构的渗透率进行比较。海外成员（占可评估答复的16%）构成一个单独的类别，用于区域分析。人口普查区的门诊就诊、全血细胞计数、头部计算机断层扫描、超声检查和食管镜检查的实践模式在统计学上存在显著差异。在常规癌症监测中，非美国会员推荐的血液检查、影像学检查和内窥镜检查明显多于美国会员。只有各大都市统计区的办公室访问频率存在显著差异。令人惊讶的是，管理式医疗机构的渗透率对治疗后监测强度没有显著影响。该分析表明，在观察到的随访实践模式的广泛变化中，只有一小部分可以用地理决定因素来解释。
BackgroundAnalysis of geographical variation in utilization of medical resources is often used to identify regions of overutilization or underutilization.MethodsWe surveyed the membership of the American Head and Neck Society regarding their recommended frequency of office visits and 13 imaging studies and blood tests for their patients after potentially curative therapy for upper aerodigestive tract cancers.ResultsOf the 1322 members surveyed, 610 (46%) responded: 420 responses (32%) were assessable. Responses were compared by US Census Region, Metropolitan Statistical Area, and managed care organization penetration rate. Overseas members (16% of assessable responses) comprised a separate category for the regional analysis. There were statistically significant variations in practice patterns among Census Regions for office visits, complete blood count, computed tomography of the head, sonography, and esophagoscopy. Non-US members recommended significantly more blood tests, imaging studies, and endoscopy than US members for routine cancer surveillance. Only the frequency of office visits differed significantly among Metropolitan Statistical Areas. Surprisingly, the penetration rate of managed care organizations had no significant effect on posttreatment surveillance intensity.ConclusionsThis analysis indicates that only a small portion of the wide variation in observed follow-up practice patterns can be explained by geographical determinants.
美国 ECT 使用情况的变化。
DOI：
10.1176/ajp.152.6.869
发表时间：
1995
期刊：
The American journal of psychiatry.
影响因子：
--
作者：
Hermann,RC;Dorwart,RA;Hoover,CW;Brody,J
通讯作者：
Brody,J