PDF(Pubmed)
Abstract：
BACKGROUND: Performing cardiovascular and cancer screenings in target populations can reduce mortality. Visiting a General Practitioner (GP) once a year is related to an increased likelihood of preventive care. The aim of this study was to analyse the influence of visiting a GP in the last year on the delivery of preventive services based on sex and household income.
METHODS: Cross-sectional study using data collected from the European Health Interview Survey 2013-2015 of individuals aged 40-74 years from 29 European countries. The variables included: sociodemographic factors (age, sex, and household income (HHI) quintiles [HHI 1: lowest income, HHI 5: more affluent]), lifestyle factors, comorbidities, and preventive care services (cardiometabolic, influenza vaccination, and cancer screening). Descriptive statistics, bivariate analyses and multilevel models (level 1: citizen, level 2: country) were performed.
RESULTS: 242,212 subjects were included, 53.7% were female. The proportion of subjects who received any cardiometabolic screening (92.4%) was greater than cancer screening (colorectal cancer: 44.1%, gynaecologic cancer: 40.0%) and influenza vaccination. Individuals who visited a GP in the last year were more prone to receive preventive care services (cardiometabolic screening: adjusted OR (aOR): 7.78, 95% CI: 7.43-8.15; colorectal screening aOR: 1.87, 95% CI: 1.80-1.95; mammography aOR: 1.76, 95% CI: 1.69-1.83 and Pap smear test: aOR: 1.89, 95% CI:1.85-1.94). Among those who visited a GP in the last year, the highest ratios of cardiometabolic screening and cancer screening benefited those who were more affluent. Women underwent more blood pressure measurements than men regardless of the HHI. Men were more likely to undergo influenza vaccination than women regardless of the HHI. The highest differences between countries were observed for influenza vaccination, with a median odds ratio (MOR) of 6.36 (under 65 years with comorbidities) and 4.30 (over 65 years with comorbidities), followed by colorectal cancer screening with an MOR of 2.26.
CONCLUSIONS: Greater adherence to preventive services was linked to individuals who had visited a GP at least once in the past year. Disparities were evident among those with lower household incomes who visited a GP. The most significant variability among countries was observed in influenza vaccination and colorectal cancer screening.
METHODS: Cross-sectional study using data collected from the European Health Interview Survey 2013-2015 of individuals aged 40-74 years from 29 European countries. The variables included: sociodemographic factors (age, sex, and household income (HHI) quintiles [HHI 1: lowest income, HHI 5: more affluent]), lifestyle factors, comorbidities, and preventive care services (cardiometabolic, influenza vaccination, and cancer screening). Descriptive statistics, bivariate analyses and multilevel models (level 1: citizen, level 2: country) were performed.
RESULTS: 242,212 subjects were included, 53.7% were female. The proportion of subjects who received any cardiometabolic screening (92.4%) was greater than cancer screening (colorectal cancer: 44.1%, gynaecologic cancer: 40.0%) and influenza vaccination. Individuals who visited a GP in the last year were more prone to receive preventive care services (cardiometabolic screening: adjusted OR (aOR): 7.78, 95% CI: 7.43-8.15; colorectal screening aOR: 1.87, 95% CI: 1.80-1.95; mammography aOR: 1.76, 95% CI: 1.69-1.83 and Pap smear test: aOR: 1.89, 95% CI:1.85-1.94). Among those who visited a GP in the last year, the highest ratios of cardiometabolic screening and cancer screening benefited those who were more affluent. Women underwent more blood pressure measurements than men regardless of the HHI. Men were more likely to undergo influenza vaccination than women regardless of the HHI. The highest differences between countries were observed for influenza vaccination, with a median odds ratio (MOR) of 6.36 (under 65 years with comorbidities) and 4.30 (over 65 years with comorbidities), followed by colorectal cancer screening with an MOR of 2.26.
CONCLUSIONS: Greater adherence to preventive services was linked to individuals who had visited a GP at least once in the past year. Disparities were evident among those with lower household incomes who visited a GP. The most significant variability among countries was observed in influenza vaccination and colorectal cancer screening.
摘要：
背景：在目标人群中进行心血管和癌症筛查可以降低死亡率。每年一次拜访全科医生（GP）与预防性护理的可能性增加有关。这项研究的目的是分析去年访问全科医生对基于性别和家庭收入的预防性服务提供的影响。
方法：横断面研究使用从2013-2015年欧洲健康访谈调查收集的数据，来自29个欧洲国家的40-74岁的个体。变量包括：社会人口因素(年龄，性别,和家庭收入(HHI)五分之一[HHI1：最低收入，HHI5：更富裕])，生活方式因素，合并症,和预防性护理服务(心脏代谢，流感疫苗接种,和癌症筛查)。描述性统计，双变量分析和多水平模型(1级：公民，第2级：国家）进行。
结果：包括242,212名受试者，53.7%为女性。接受任何心脏代谢筛查的受试者比例（92.4％）大于癌症筛查（结直肠癌：44.1％，妇科癌症：40.0％）和流感疫苗接种。在过去一年中访问过全科医生的个人更倾向于接受预防性护理服务（心脏代谢筛查：调整后的OR（aOR）：7.78，95％CI：7.43-8.15；结直肠筛查aOR：1.87，95％CI：1.80-1.95；乳房X线照相术aOR：1.76，95％CI：1.69-1.83和巴氏涂片检查：aOR：1.89，95％CI在去年参观过全科医生的人中，心脏代谢筛查和癌症筛查比例最高的人群受益于较富裕的人群.无论HHI如何，女性都比男性接受更多的血压测量。无论HHI如何，男性比女性更有可能接受流感疫苗接种。各国之间的流感疫苗接种差异最大，中位数赔率比（MOR）为6.36（65岁以下合并疾病）和4.30（65岁以上合并疾病），随后是MOR为2.26的结直肠癌筛查。
结论：对预防服务的更高依从性与过去一年中至少访问过全科医生的个体有关。家庭收入较低的去过全科医生的人之间存在明显的差异。各国之间的差异最大的是流感疫苗接种和结直肠癌筛查。
方法：横断面研究使用从2013-2015年欧洲健康访谈调查收集的数据，来自29个欧洲国家的40-74岁的个体。变量包括：社会人口因素(年龄，性别,和家庭收入(HHI)五分之一[HHI1：最低收入，HHI5：更富裕])，生活方式因素，合并症,和预防性护理服务(心脏代谢，流感疫苗接种,和癌症筛查)。描述性统计，双变量分析和多水平模型(1级：公民，第2级：国家）进行。
结果：包括242,212名受试者，53.7%为女性。接受任何心脏代谢筛查的受试者比例（92.4％）大于癌症筛查（结直肠癌：44.1％，妇科癌症：40.0％）和流感疫苗接种。在过去一年中访问过全科医生的个人更倾向于接受预防性护理服务（心脏代谢筛查：调整后的OR（aOR）：7.78，95％CI：7.43-8.15；结直肠筛查aOR：1.87，95％CI：1.80-1.95；乳房X线照相术aOR：1.76，95％CI：1.69-1.83和巴氏涂片检查：aOR：1.89，95％CI在去年参观过全科医生的人中，心脏代谢筛查和癌症筛查比例最高的人群受益于较富裕的人群.无论HHI如何，女性都比男性接受更多的血压测量。无论HHI如何，男性比女性更有可能接受流感疫苗接种。各国之间的流感疫苗接种差异最大，中位数赔率比（MOR）为6.36（65岁以下合并疾病）和4.30（65岁以上合并疾病），随后是MOR为2.26的结直肠癌筛查。
结论：对预防服务的更高依从性与过去一年中至少访问过全科医生的个体有关。家庭收入较低的去过全科医生的人之间存在明显的差异。各国之间的差异最大的是流感疫苗接种和结直肠癌筛查。
