患有和未患有精神分裂症的女性医疗补助受益人的宫颈癌筛查。

IF 5.3 1区 医学 Q1 PSYCHIATRY
Alison R Hwong, Karly A Murphy, Eric Vittinghoff, Paola Alonso-Fraire, Stephen Crystal, Jamie Walkup, Richard Hermida, Mark Olfson, Francine Cournos, George F Sawaya, Christina Mangurian
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引用次数: 0

摘要

背景与假设:在美国,患有精神分裂症的女性在接受妇科治疗方面面临着挑战,但对于宫颈癌筛查率在不同时期或不同州的公共保险人群中的差异却知之甚少。我们假设,在全美范围内,与对照人群相比,患有精神分裂症的女性医疗补助受益人接受宫颈癌筛查的可能性较低,而患有精神分裂症和其他易感标记的女性接受筛查的可能性最低:这项回顾性队列研究使用了美国 44 个州在 2002 年至 2012 年期间的医疗补助管理数据,研究了 283 950 名患有精神分裂症的女性医疗补助受益人与根据年龄和种族/族裔匹配的无严重精神疾病的频率匹配对照组在宫颈癌筛查率方面的差异。在患有精神分裂症的女性中,多变量逻辑回归利用个人社会人口统计学、合并症和医疗保健服务利用率估算了接受宫颈癌筛查的几率:与对照组相比,精神分裂症女性接受宫颈癌筛查的几率较低(OR = 0.76; 95% CI 0.75-0.77)。在患有精神分裂症的女性中,非白人、年轻女性、城市居民、患有药物使用障碍、焦虑症和抑郁症的女性以及与初级保健机构有联系的女性更有可能完成筛查:患有精神分裂症的美国女性医疗补助受益人的宫颈癌筛查率并不理想。为解决这一人群在宫颈癌护理方面的差异,需要采取干预措施,优先考虑那些与医疗保健系统接触较少或居住在农村地区的精神分裂症女性患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cervical Cancer Screening Among Female Medicaid Beneficiaries With and Without Schizophrenia.

Background and hypothesis: In the United States, women with schizophrenia face challenges in receiving gynecologic care, but little is known about how cervical cancer screening rates vary across time or states in a publicly insured population. We hypothesized that women Medicaid beneficiaries with schizophrenia would be less likely to receive cervical cancer screening across the United States compared with a control population, and that women with schizophrenia and other markers of vulnerability would be least likely to receive screening.

Study design: This retrospective cohort study used US Medicaid administrative data from across 44 states between 2002 and 2012 and examined differences in cervical cancer screening test rates among 283 950 female Medicaid beneficiaries with schizophrenia and a frequency-matched control group without serious mental illness, matched on age and race/ethnicity. Among women with schizophrenia, multivariable logistic regression estimated the odds of receiving cervical cancer screening using individual sociodemographics, comorbid conditions, and health care service utilization.

Study results: Compared to the control group, women with schizophrenia were less likely to receive cervical cancer screening (OR = 0.76; 95% CI 0.75-0.77). Among women with schizophrenia, nonwhite populations, younger women, urban dwellers, those with substance use disorders, anxiety, and depression and those connected to primary care were more likely to complete screening.

Conclusions: Cervical cancer screening rates among US women Medicaid beneficiaries with schizophrenia were suboptimal. To address cervical cancer care disparities for this population, interventions are needed to prioritize women with schizophrenia who are less engaged with the health care system or who reside in rural areas.

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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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