기사
Continuity of Care and Cancer Screening Among Health Plan Enrollees /
- 개인저자
- Fenton, Joshua. et al
- 수록페이지
- 58-62 p.
- 발행일자
- 2008.01.10
- 출판사
- Lippincott
초록
[영문]CONTEXT:: Although having a usual source of care has been associated with cancer screening, whether there is additional benefit from continuity with a specific physician is uncertain. In addition, little is known about the relationship between continuity of care and receipt of colorectal and prostate cancer screening. METHODS:: Subjects were enrolled in a Washington State health plan that operates an integrated delivery system that emphasizes access to primary care. Among patients age 50?78 years old with 2 or more primary care visits in 2002?2003 (N = 67,633), we determined whether higher continuity (=50% of visits with the most visited primary care provider) was associated with colorectal, breast, and prostate cancer screening. Random-effects logistic regression estimated adjusted percentages of patients who received fecal occult blood testing, lower endoscopy (sigmoidoscopy or colonoscopy), screening mammography, and prostate specific antigen (PSA) testing. RESULTS:: Patients with higher continuity were more likely to receive fecal occult blood testing than patients with lower continuity (28.9% vs. 26.8%; P qqqlt; 0.001) but less likely to receive lower endoscopy (12.9% vs. 14.3%; P qqqlt; 0.001). Although higher continuity was not significantly associated with screening mammography (P = 0.38), men with higher continuity were more likely to receive PSA testing than men with lower continuity (39.4% vs. 37.4%; P = 0.008). CONCLUSIONS:: In an insured population with a high degree of primary care access, continuity with a specific primary care physician was associated with the selection of less invasive colorectal cancer screening tests by patients and physicians and greater likelihood of PSA testing.