多层次的预测指标是最新的结直肠癌查
Kristen Hassmiller Lich1, Sarah D Mills2,3, Tzy-Mey Kuo3
1Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105E McGavran-Greenberg Hall, Chapel Hill, NC, CB #7411, USA. klich@unc.edu.
了解结直肠癌 (CRC) 查的因素是关键. 这项研究确定了个人和县级预测因素,以改善针对CRC查遵守的有针对性的干预措施.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠直肠癌 (CRC) 查对于早期检测和改善患者结果至关重要.
- 识别与CRC查遵守相关的因素对于开发有效的公共卫生干预措施至关重要.
研究的目的:
- 评估与最新的结直肠癌 (CRC) 查相关的个人和县级因素.
- 为旨在提高CRC查率的干预措施的定向提供信息.
主要方法:
- 北卡罗来纳州居民使用的医疗保险和私人保险索赔数据 (2012-2016).
- 根据USPSTF针对59-75岁的个人指南,定义了基于USPSTF指南的最新CRC查状态.
- 采用了概括估计方程逻辑回归模型,包括个人和县级数据.
主要成果:
- 75%的样本 (n=274,660) 是最新的CRC查.
- 确定了个人层面的显著预测因素,包括年龄,保险类型和初级保健访问.
- 确定了重要的县级预测指标,如教育水平,保险费率和失业率.
- 年龄较大 (73-75岁) 和生活在有更多初级保健医生的地区,与保持最新状态的可能性更高有关.
结论:
- 发现12个个人和县级的人口特征与CRC查遵守有关.
- 这些发现可以指导开发有针对性的干预措施,以提高CRC查率.
- 优化干预策略需要了解个人和地理因素的相互作用.
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