结肠直肠癌查和社会需求
Isabelle R Franklin1, Rebecca Gambatese2, Mark C Duggan2
1From the Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA (IRF, EEH, CAS); Kaiser Permanente Bernard J. Tyson School of Medicine, Office of Research and Scholarship, Pasadena, CA (RG, MCD); Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, Pasadena, CA (BBG, RSN, QNM); Kaiser Permanente Washington Health Research Institute, Seattle, WA (BBN); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (GDC); Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, CA (EEH); Hawaii Permanente Medical Group, Honolulu, HI (SAH); The Southeast Permanente Medical Group, Atlanta, GA (KK); Kaiser Permanente Division of Research, Oakland, CA (TRL); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (CAS). isabelle.r.franklin@kp.org).
经济压力,社会隔离和粮食不安全等社会需求显著影响结肠直肠癌 (CRC) 查率,即使在保险人口中也是如此. 解决这些健康的社会决定因素对于改善CRC查至关重要. 关键词:结直肠癌查,社会需要,经济压力,社会隔离,粮食不安全.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 健康差异 在健康上的差异
背景情况:
- 大肠直肠癌 (CRC) 是美国癌症死亡的主要原因.
- 已知有患者报告的对CRC查的障碍,但对社会需求的影响不太了解.
- 很少有研究分析了社会需求如何影响CRC查率.
研究的目的:
- 调查患者的社会需求与他们遵守结直肠癌 (CRC) 查指南之间的联系.
- 确定特定的社会需求,这些需求是CRC查完成的障碍.
- 通过解决健康的社会决定因素,为提高CRC查率的策略提供信息.
主要方法:
- 这是一项对3443名年龄在50至75岁的凯撒永久医院患者进行的横截面研究.
- 评估了五个社会需求类别:财务压力,住房不稳定,交通问题,社会隔离和粮食不安全.
- 使用基于医疗保健有效性数据和信息 (HEDIS) 标准的电子健康记录来确定CRC查状态;使用多变量分析分析了分析的关联.
主要成果:
- 81.5%的患者在CRC查方面是最新的.
- 严重的财务压力 (OR 2.1),社会隔离 (OR 1.9) 和粮食不安全 (OR 2.5) 与在查方面保持最新的几率明显较低有关.
- 严重的运输问题和住房不稳定性显示了向较低查率的非显著趋势.
结论:
- 社会需求,包括经济压力,社会隔离和粮食不安全,与较低的CRC查率有关,即使在完全保险的个人中也是如此.
- 解决健康的社会决定因素对于提高CRC查遵守率至关重要.
- 未来的研究应该探索针对社会需求的干预措施,以改善CRC查.
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