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促进初级保健提供者对高风险患者进行肺癌查
Marco Colamonici1,2, Nader Khouzam1,2, Catherine Dell1
1Medical Service, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, USA.
初级保健提供者通过质量改进项目增加了肺癌查转诊率. 然而,与社会经济因素和运输障碍相关的显著的不出现率被观察到,需要进一步研究.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是指放射学
- 公共卫生 公共卫生
背景情况:
- 使用低剂量计算机断层扫描 (LDCT) 的肺癌查率仍然低于最佳水平.
- 初级保健提供者 (PCP) 在增加患者获得LCS方面发挥着至关重要的作用.
研究的目的:
- 通过PCP来增加适当的LCS转介.
- 评估质量改进 (QI) 项目的对LCS转诊和结果的影响.
主要方法:
- 一个QI项目从2021年4月到2022年6月实施.
- 关键组成部分包括患者教育,与PCP共享决策 (SDM) 和跟踪LDCT完成.
- 计算了延迟时间 (LT) 到LCS和包装年 (PYs);进行了患者邮政编码的地理映射.
主要成果:
- 每周从PCP获得的LCS转诊数量立即增加并持续增长.
- 该队列包括95%的男性,黑人患者比例更高.
- 少数群体患者的平均PY较低,但平均LT较高;白人患者的平均LT较高.
- 25%的退伍军人是没有出现的,许多人居住在过境沙漠.
- 肺RADS得分4B/4X是预期患病率的两倍多.
结论:
- 通过QI项目,PCP成功地增加了LCS推.
- 显著的不出现率表明了复杂的种族和社会经济因素,包括交通障碍.
- 观察到肺RADS得分4B/4X的患病率高于预期.
- 需要一个大型的多站点QI项目来解决高风险人群的交通障碍.
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