自我收集HPV检测:与联邦合格卫生中心的绩效测量和质量改进相关的潜在问题
Amanda Le1, Stephanie B Wheeler, Jennifer Elston Lafata
1Departments of Public Health Leadership (Ms Le and Dr L. S. Smith), Health Policy and Management (Dr Wheeler), and Epidemiology (Dr J. S. Smith), Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center (Drs Wheeler, Lafata, and J. S. Smith, Mr Teal, and Ms Giannone), Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy (Dr Lafata), and Connected Health Applications and Interventions (CHAI-Core) (Mr Teal and Ms Giannone), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Blue Ridge Health, Hendersonville, North Carolina (Dr Zaffino).
人类乳头瘤病毒 (HPV) 自收集可以改善联邦合格卫生中心 (FQHCs) 的宫癌查. 解决成本和监管批准等实施障碍对于成功采用和改善质量措施至关重要.
科学领域:
- 公共卫生 公共卫生
- 妇科瘤学 妇科瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 不充分的宫癌查是美国发生病例的主要原因.
- 联邦合格卫生中心 (FQHC) 服务于高风险人群,但在维持适当的查率方面经常面临挑战.
- 人类乳头瘤病毒 (HPV) 自收集为改善这些服务不足的环境中的查覆盖率提供了一个潜在的解决方案.
研究的目的:
- 探索临床人员对北卡罗来纳州FQHCs当前宫癌查率的观点.
- 评估实施HPV自收集对未查患者查率和绩效指标的预期影响.
- 在FQHC中确定HPV自收集实施的障碍和促进因素.
主要方法:
- 使用焦点小组和关键信息人采访进行定性研究.
- 对成绩单进行主题分析,以确定新出现的主题.
- 将主题映射到实施研究综合框架 (CFIR) 结构中.
主要成果:
- 社会,实践和患者层面的因素导致宫癌查率较低.
- 预计HPV自收集将通过提供灵活的查选项来增加查采用率并改善质量措施.
- 实施的主要障碍包括财务问题和缺乏FDA对HPV自收集测试的批准.
结论:
- 在FQHC中,HPV自收集显示出提高宫癌查质量和性能的前景.
- 解决影响查普及的多层次因素对于成功实施至关重要.
- 财务影响和监管批准是广泛采用的关键考虑因素.
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