Access

You are not currently logged in.

Access JSTOR through your library or other institution:

login

Log in through your institution.

Journal Article

Cancer Screening in Public Health Clinics: The Importance of Clinic Utilization

Joan R. Bloom, Susan L. Stewart, Jocelyn Koo and Robert A. Hiatt
Medical Care
Vol. 39, No. 12 (Dec., 2001), pp. 1345-1351
Stable URL: http://www.jstor.org/stable/3768107
Page Count: 7
Were these topics helpful?
See something inaccurate? Let us know!

Select the topics that are inaccurate.

Cancel
  • More info
  • Add to My Lists
  • Cite this Item
Cancer Screening in Public Health Clinics: The Importance of Clinic Utilization
Preview not available

Abstract

Objectives. To determine how screening for breast and cervical cancer in public health clinics was associated with overall clinic utilization. Methods. Evidence of screening and clinic visits between June 1989 and May 1992 was obtained by medical record audit for a random sample of 1825 women aged 40 to 75 attending eight public health clinics in the San Francisco Bay Area. Results. With an average number of visits (4 per year), women who did not receive a physical examination were much less likely than those who did to obtain a clinical breast examination (OR = 0.03), mammography referral (OR = 0.1), or a mammogram (OR = 0.4) within 2 years, or a Papanicolaou smear (OR = 0.1) within 3 years. Without a physical examination, the odds of screening or referral increased with the first visit (OR = 1.2 for referral, breast examination, and Pap; 1.3 for mammography), but with a decreasing marginal effect of each additional visit (ratio of successive one-visit OR values = 0.992 for referral and breast examination; 0.995 for Pap; 0.98 for mammography). With a physical exam, visits were associated with mammography only (first visit OR = 1.2; OR ratio = 0.992). Conclusions. In public health clinics, screening is associated either with receipt of routine care or repeated visits for treatment. Women who fall through the cracks are those who come to the clinic with a medical problem but otherwise receive few services. Interventions in public health clinics need to facilitate the provider's ability to use medically related visits as opportunities to increase adherence to screening recommendations.

Page Thumbnails

  • Thumbnail: Page 
1345
    1345
  • Thumbnail: Page 
1346
    1346
  • Thumbnail: Page 
1347
    1347
  • Thumbnail: Page 
1348
    1348
  • Thumbnail: Page 
1349
    1349
  • Thumbnail: Page 
1350
    1350
  • Thumbnail: Page 
1351
    1351
Part of Sustainability