Variations in practice guideline adherence for abnormal cervical cytology in a county healthcare system
Variations in practice guideline adherence for abnormal cervical cytology in a county healthcare system
复制标题
DOI：
10.1007/s11606-008-0528-x
复制
发表时间：
2008-05-01
影响因子：
5.7
通讯作者：
Holschneider, Christine H.
中科院分区：
文献类型：
--
作者：
Singhal, Rita;Rubenstein, Lisa V.;Holschneider, Christine H.
BACKGROUND: Reduction in cervical cancer incidence and mortality is not only dependant on promoting cervical cancer screening but also on providing appropriate follow-up and treatment of abnormal cervical cytology.OBJECTIVES: The objective of this study was to determine variations in guideline adherence for women requiring abnormal cervical cytology follow-up.SUBJECTS: Subjects of the study are women 18 years or older with an abnormal Pap test in 2000 within a large county healthcare system (n=8,571).MEASUREMENTS: Guideline adherence was determined by the presence or absence of the appropriate follow-up procedure within an acceptable time interval for each degree of cytological abnormality. Patients with no follow-up studies were deemed to be lost to follow-up.RESULTS: Of study subjects, 18.5% were lost to follow-up care. Of the remaining 6,987 women, 60.3% received optimal care, 9.4% received suboptimal care, and 30.3% received poor care. Follow-up rates were higher for patients with higher degree of cytological abnormality (OR, 1.29, 95% CI, 1.17-1.42), older patients (OR, 1.03, 95% CI, 1.02-1.030) and those receiving the index Pap test at a larger healthcare facility (OR, 1.13; 95% CI, 1.01-1.27). Receiving optimal care was positively correlated with higher degree of cytological abnormality (p
