负担得起的医疗保健法案》的实施与妇女接受过子宫颈抹片检查的比例之间的关系。

IF 0.9 4区 医学 Q4 OBSTETRICS & GYNECOLOGY
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-08-23 DOI:10.1080/01443615.2024.2393359
Eric M Ganz, Benjamin Brown, Heather Smith, Lawren Wellisch, Megha Gupta, Stephen M Wagner
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引用次数: 0

摘要

背景:目的:评估 2010 年《患者保护与可负担医疗法案》(ACA)的实施是否与妇女接受过子宫颈抹片检查的比例变化有关:本研究利用了疾病控制中心公开的全国家庭成长调查(NSFG)数据集。这是一项连续的横断面研究。对比组被定义为在全面实施《美国癌症法案》之前(2011-2013 年)和全面实施之后(2017-2019 年)接受癌症筛查和预防干预的妇女。主要结果是自我报告接受了巴氏涂片检查。次要结果包括 HPV 疫苗接种率和乳房 X 光检查率。从全国代表性数据集收集匿名患者信息,并利用 STATA 18 进行分析:从NSFG获得的两个研究队列包括2011-2013年(n = 5601)回复的妇女,被视为 "ACA实施前"(Pre ACA),以及2017-2019年(n = 6141)回复的妇女,被视为 "ACA实施后"(Post ACA)。ACA实施前 "组(96.0%)中21岁及以上曾接受过巴氏涂片检查的女性比例高于 "ACA实施后 "组(94.1%)(OR值为0.66 (0.49-0.91))。相比之下,ACA 后的 HPV 疫苗接种率有所上升,乳房 X 光检查率保持稳定:结论:尽管实施了提高预防措施普及率的卫生政策,但接受过子宫颈抹片检查的妇女比例却有所下降,这表明有必要采取进一步的干预措施来提高宫颈癌筛查的普及率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The association between affordable care act implementation and the prevalence of women having ever received a Pap smear.

Background: To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear.

Methods: This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (NSFG) data set. This was a serial cross-sectional study. The comparison groups were defined as women who received cancer screening and prevention interventions prior to full implementation of the ACA (2011-2013) and post full implementation (2017-2019). The primary outcome was self-reporting receipt of a Papanicolaou (Pap) smear. Secondary outcomes included HPV vaccination and mammogram rates. Anonymized patient information was collected from the nationally representative dataset, and analyses were performed utilising STATA 18.

Results: The two study cohorts obtained from the NSFG included women who responded in 2011-2013 (n = 5601), deemed to be 'Pre-ACA implementation' (Pre ACA), and those who responded in 2017-2019 (n = 6141) 'Post-ACA implementation' (Post ACA). The proportion of women who were 21 years and older and ever had a Pap smear in the Pre ACA group (96.0%) was higher than that of the Post ACA group (94.1%) (OR 0.66 (0.49-0.91)). In contrast, HPV vaccination rates rose, and mammogram rates remained stable in the Post ACA period.

Conclusion: A decrease in proportion of women ever having had a Pap smear despite implementation of health policies to increase access to preventive measures suggests further interventions to improve access to cervical cancer screening are warranted.

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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
398
审稿时长
6 months
期刊介绍: Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.
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