Organizational Change: A Way to Increase Colon, Breast and Cervical Cancer Screening in Primary Care Practices

2010 ◽  
Vol 36 (2) ◽  
pp. 281-288 ◽  
Author(s):  
Ana Maria Arroyave ◽  
Eribeth K. Penaranda ◽  
Carmen L. Lewis
Keyword(s):  
Primary Care ◽  
Cervical Cancer ◽  
Organizational Change ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Breast And Cervical Cancer ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Associations of types of primary care facilities with adult vaccination and cancer screening in Japan

2020 ◽  
Vol 32 (6) ◽  
pp. 373-378
Author(s):  
Takuya Aoki ◽  
Shunichi Fukuhara
Keyword(s):  
Primary Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Preventive Care ◽  
Breast And Cervical Cancer ◽  
Adult Vaccination ◽  
Care Facilities ◽  
Care Practices ◽  
Primary Care Practices

Abstract Objective To examine the association between primary care facility types and the quality of preventive care, especially adult vaccination and cancer screening, with a focus on the differences between community clinics and hospitals. Design Multicenter cross-sectional study. Setting A primary care practice-based research network in Japan (25 primary care facilities). Participants Adult outpatients for whom the participating facility serves as their usual source of care. Intervention None. Main Outcome Measures Influenza and pneumococcal vaccination delivery and performance of colorectal, breast and cervical cancer screening. Results Data collected from 1725 primary care outpatients were analyzed. After adjustment of possible confounders and clustering within facilities, hospital-based practices were significantly associated with poorer uptake of influenza [adjusted odds ratio (aOR) = 0.64, 95% confidence interval (CI) 0.42–0.96] and pneumococcal vaccines (aOR = 0.55, 95% CI 0.40–0.75) and colorectal cancer screening (aOR = 0.59, 95% CI 0.39–0.88) compared with clinic-based practices. In contrast, the associations of types of primary care facilities with uptake of breast and cervical cancer screening were not statistically significant. Conclusions Differences in the performance of adult vaccination and cancer screening raised concerns about the provision of preventive care at hospital-based compared with clinic-based primary care practices. Efforts to improve preventive care at hospital-based primary care practices should help to promote equalization of the quality of primary care. Further study is needed on the comparisons of other quality indicators among different structures of primary care facilities.

scholarly journals Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

2016 ◽  
Vol 31 (10) ◽  
pp. 1148-1155 ◽  
Author(s):  
Marilyn M. Schapira ◽  
◽  
Brian L. Sprague ◽  
Carrie N. Klabunde ◽  
Anna N. A. Tosteson ◽  
...  
Keyword(s):  
Primary Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Primary Care Practice ◽  
Care Practice ◽  
Breast And Cervical Cancer

Breast and cervical cancer screening disparities among transgender patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7024-7024
Author(s):  
Oluwadamilola Temilade Oladeru ◽  
Sung Jun Ma ◽  
Joseph Miccio ◽  
Katy Wang ◽  
Kristopher Attwood ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cervical Cancer Screening ◽  
Care Physician ◽  
Weighted Estimate ◽  
Cross Sectional ◽  
Breast And Cervical Cancer

7024 Background: Over a million Americans identify themselves as transgender and this population is growing. Transgender status was a pre-existing condition prior to the Affordable Care Act (ACA), and transgender individuals faced unique disparities in gender-specific cancer screening in part due to discrimination in health insurance coverage. Modern literature for transgender adults’ adherence to cancer screening is limited. To fill this knowledge gap, we conducted a cross sectional study to investigate transgender individuals’ self-reported adherence to cancer screening and access to primary care compared to cisgender individuals. Methods: The Behavioral Risk Factor Surveillance System database was queried for transgender (either male-to-female [MTF] or female-to-male [FTM]) and cisgender adults from 2014-2016 and 2018. Primary endpoints were adherence to breast and cervical cancer screening guidelines and access to primary health care. Those with prior hysterectomy, breast and cervical cancer were excluded. Multivariable logistic regression was performed to evaluate the association of transgender status with cancer screening and healthcare access, after adjusting for demographic characteristics and survey weights. Results: A total of 219,665 and 206,446 participants were eligible for breast and cervical cancer screening, respectively. Of those, 614 (0.28%) and 587 (0.29%) transgender participants were eligible for each cancer screening type, respectively, representing a weighted estimate of nearly 200,000 transgender participants total. When compared to cisgender counterparts, transgender participants were less likely to adhere to breast cancer screening (FTM: OR 0.47, p < 0.001; MTF: OR 0.04, p < 0.001) and to have received any breast cancer screening (FTM: OR 0.32, p < 0.001; MTF: OR 0.02, p < 0.001). Similarly, FTM participants were less likely to adhere to cervical cancer screening (OR 0.42, p < 0.001) and to have received any cervical cancer screening (OR 0.26, p < 0.001). In addition, transgender participants were more likely to have no primary care physician (FTM: OR 0.79, p < 0.001; MTF: OR 0.58, p < 0.001) and to be unable to see a physician when needed within the past year due to medical cost (FTM: OR 1.44, p < 0.001; MTF: OR 1.36, p < 0.001). Conclusions: Despite the implementation of the ACA, limited primary care access and poor adherence to breast and cervical cancer screening are evident for transgender populations. Further research efforts to improve the utilization of preventive cancer services are needed for this underserved population.

scholarly journals Breast and Cervical Cancer Screening Among Medicaid Beneficiaries: The Role of Physician Payment and Managed Care

2018 ◽  
Vol 77 (1) ◽  
pp. 34-45 ◽  
Author(s):  
Lindsay M. Sabik ◽  
Bassam Dahman ◽  
Anushree Vichare ◽  
Cathy J. Bradley
Keyword(s):  
Primary Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Managed Care ◽  
Case Management ◽  
Cervical Cancer Screening ◽  
Physician Payment ◽  
Breast And Cervical Cancer ◽  
Screening Services ◽  
The Relationship

Medicaid-insured women have low rates of cancer screening. There are multiple policy levers that may influence access to preventive services such as screening, including physician payment and managed care. We examine the relationship between each of these factors and breast and cervical cancer screening among nonelderly nondisabled adult Medicaid enrollees. We combine individual-level data on Medicaid enrollment, demographics, and use of screening services from the Medicaid Analytic eXtract files with data on states’ Medicaid-to-Medicare fee ratios and estimate their impact on screening services. Higher physician fees are associated with greater screening for comprehensive managed care enrollees; for enrollees in fee-for-service Medicaid, the findings are mixed. Patient participation in primary care case management is a significant moderator of the relationship between physician fees and the rate of screening, as interactions between enrollee primary care case management status and the Medicaid fee ratio are consistently positive across models of screening.

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