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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/21976292 below:

Systems strategies to support cancer screening in U.S. primary care practice

. 2011 Dec;20(12):2471-9. doi: 10.1158/1055-9965.EPI-11-0783. Epub 2011 Oct 5. Systems strategies to support cancer screening in U.S. primary care practice

Affiliations

Affiliation

¹ Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA. yabroffr@mail.nih.gov

PMID: 21976292
PMCID: PMC3237756
DOI: 10.1158/1055-9965.EPI-11-0783

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Systems strategies to support cancer screening in U.S. primary care practice

K Robin Yabroff et al. Cancer Epidemiol Biomarkers Prev. 2011 Dec.

. 2011 Dec;20(12):2471-9. doi: 10.1158/1055-9965.EPI-11-0783. Epub 2011 Oct 5. Affiliation

¹ Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA. yabroffr@mail.nih.gov

PMID: 21976292
PMCID: PMC3237756
DOI: 10.1158/1055-9965.EPI-11-0783

Item in Clipboard

Abstract

Background: Although systems strategies are effective in improving health care delivery, little is known about their use for cancer screening in U.S. primary care practice.

Methods: We assessed primary care physicians' (N = 2,475) use of systems strategies for breast, cervical, and colorectal cancer (CRC) screening in a national survey conducted in 2007. Systems strategies included patient and physician screening reminders, performance reports of screening rates, electronic medical records, implementation of in-practice guidelines, and use of nurse practitioners/physician assistants. We evaluated use of both patient and physician screening reminders with other strategies in separate models by screening type, adjusted for the effects of physician and practice characteristics with multivariate logistic regression.

Results: Fewer than 10% of physicians used a comprehensive set of systems strategies to support cancer screening; use was greater for mammography and Pap testing than for CRC screening. In adjusted analyses, performance reports of cancer screening rates, medical record type, and in-practice guidelines were associated with use of both patient and physician screening reminders for mammography, Pap testing, and CRC screening (P < 0.05).

Conclusion: Despite evidence supporting use of systems strategies in primary care, few physicians report using a comprehensive set of strategies to support cancer screening.

Impact: Current health policy initiatives underscore the importance of increased implementation of systems strategies in primary care to improve the use and quality of cancer screening in the United States.

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Figures
Figure 1

Use of Reports Regarding Rates…

Figure 1

Use of Reports Regarding Rates of Screening and Both Patient and Physician Reminders…

Figure 1

Use of Reports Regarding Rates of Screening and Both Patient and Physician Reminders in Primary Care Practice, by Screening Type * Association between reports and use of both patient and physician reminders statistically significant at p<0.05. Adjusted for physician age, specialty, percentage of patients insured by Medicaid, geographic region, practice size, and practice type using survey specific sample weights. Predicted marginals and 95% CIs are reported as percentages.

Figure 2

Type of Medical Records System…

Figure 2

Type of Medical Records System and Use of Both Patient and Physician Reminders…

Figure 2

Type of Medical Records System and Use of Both Patient and Physician Reminders in Primary Care Practice, by Screening Type * Association between type of medical record and use of both patient and physician reminders statistically significant at p<0.05. Adjusted for physician age, specialty, percentage of patients insured by Medicaid, geographic region, practice size, and practice type using survey specific sample weights. Predicted marginals and 95% CIs are reported as percentages.

Figure 3

Use of In-Practice Guidelines for…

Figure 3

Use of In-Practice Guidelines for Screening and Both Patient and Physician Reminders in…

Figure 3

Use of In-Practice Guidelines for Screening and Both Patient and Physician Reminders in Primary Care Practice, by Screening Type * Association between use of guidelines and both patient and physician reminders statistically significant at p<0.05. Adjusted for physician age, specialty, percentage of patients insured by Medicaid, geographic region, practice size, and practice type using survey specific sample weights. Predicted marginals and 95% CIs are reported as percentages.