质量改进干预,以增加在初级保健机构的结直肠癌查:一个集群随机对照试验
Vilma Irazola1, Marilina Santero2, Mario Sanchez3
1Department of Research on Chronic Diseases, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina virazola@iecs.org.ar.
BMJ open quality
|June 20, 2023
概括
在阿根廷,质量改善干预显著增加了结直肠癌 (CRC) 查. 这一战略提高了初级保健中有效的CRC查率,解决了关键的公共卫生需求.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠直肠癌 (CRC) 是阿根廷第二常见的癌症,导致慢性非传染性疾病的高负担.
- 尽管建议每年对50至75岁的成年人进行便免疫化学测试 (FIT),但阿根廷的CRC查率仍低于20%.
研究的目的:
- 评估质量改善干预措施在提高CRC查率的有效性,在阿根廷的初级保健机构使用FIT.
- 通过实用的集群随机对照试验来解决低选采用率的问题.
主要方法:
- 在阿根廷门多萨的十个公共初级卫生中心进行了为期18个月的两臂实用集群随机对照试验.
- 干预使用了Plan-Do-Study-Act周期,通过FIT提高CRC查率.
- 主要结局是有效的CRC查率;次要结局包括积极的FIT结果,无效测试和结肠镜转诊.
主要成果:
- 有效的CRC查在干预组 (75%) 与对照组 (54.2%) 相比显著增加,赔率比为2.5 (p=0.001).
- 在调整了人口统计和社会经济因素后,这些发现是强有力的.
- 在两支手臂之间,没有观察到积极的FIT结果 (总体17.7%) 或不充分的测试结果 (总体5.2%) 的显著差异.
结论:
- 质量改善策略在提高阿根廷公共初级医疗保健系统内的CRC查率方面非常有效.
- 这项干预措施证明了成功地提高了参与推的癌症查计划的成功方法.
相关概念视频
01:30Preventive Healthcare Services
1.1K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
1.1K
01:25Endoscopic Procedures II: Colonoscopy
139
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
139
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
114
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
114
01:30Primary Healthcare Services
1.4K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.4K
02:59Cancer Prevention
6.2K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
6.2K
01:25Assessment of the Rectum and Anus
288
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
288