Cancer screening in public health clinics: The importance of clinic utilization

Joan R. Bloom, Susan L Stewart, Jocelyn Koo, Robert A. Hiatt

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1345-1351
Number of pages7
JournalMedical Care
Volume39
Issue number12
DOIs
StatePublished - Dec 2001
Externally publishedYes

Fingerprint

Mammography
Early Detection of Cancer
cancer
Referral and Consultation
Public Health
public health
utilization
examination
Breast
Physical Examination
Medical Audit
Papanicolaou Test
San Francisco
Ambulatory Care
Uterine Cervical Neoplasms
Medical Records
audit
random sample
Breast Neoplasms
ability

Keywords

  • Cancer
  • Health behaviors
  • Health-services utilization
  • Prevention, secondary

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Cancer screening in public health clinics : The importance of clinic utilization. / Bloom, Joan R.; Stewart, Susan L; Koo, Jocelyn; Hiatt, Robert A.

In: Medical Care, Vol. 39, No. 12, 12.2001, p. 1345-1351.

Research output: Contribution to journalArticle

Bloom, Joan R. ; Stewart, Susan L ; Koo, Jocelyn ; Hiatt, Robert A. / Cancer screening in public health clinics : The importance of clinic utilization. In: Medical Care. 2001 ; Vol. 39, No. 12. pp. 1345-1351.
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