在综合卫生系统中,在便测试结果呈阳性后,随访结肠镜检查的频率和时间.
Christina P Wang1, Ankit M Shah2, Matthew Y Zhao2
1Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, USA. Christina.Wang@mountsinai.org.
在便检测结果呈阳性后及时完成后续结肠镜检查是不理想的,特别是在年长,病情较严重的患者中. 需要系统层面的干预来克服障碍,例如错过预约和取消结直肠癌查的障碍.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在便检测结果呈阳性后,随访结肠镜检查的完成率在医疗机构之间有很大差异.
- 延迟结肠镜检查 (在便检查结果呈阳性后超过6个月) 与结肠直肠癌发病率较差的结果有关.
研究的目的:
- 评估在城市卫生系统中,在便检测结果呈阳性后,及时完成后续结肠镜检查的比率.
- 确定与及时结肠镜检查和完成障碍相关的因素.
主要方法:
- 对701名患者 (45至75岁) 进行了回顾性研究,他们的便测试呈阳性.
- 及时 (≤180天) 和特定点 (90,365天) 结肠镜完成率的分析.
- 多变量考克斯模型和帕雷托分析以确定预测因素和障碍.
主要成果:
- 只有59.6%的患者及时完成了随访结肠镜检查 (≤180天).
- 患者外展改善了52%的及时完成,而直接访问患者完成的可能性较低.
- 关键障碍包括错过的胃肠病学预约,患者拒绝和手术取消/不出现.
结论:
- 在这个老年,共患病的人群中,及时完成结肠镜检查的速度是不理想的.
- 系统层面的因素极大地影响了结肠镜检查的及时完成.
- 通过干预措施识别和解决障碍,可以改善及时的随访和潜在的结直肠癌结果.
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