Office Systems and Their Influence on Mammography Use in Rural and Urban Primary Care

Autor/inn/en	Engelman, Kimberly K.; Ellerbeck, Edward F.; Perpich, Denise; Nazir, Niaman; McCarter, Kevin; Ahluwalia, Jasjit S.
Titel	Office Systems and Their Influence on Mammography Use in Rural and Urban Primary Care
Quelle	In: Journal of Rural Health, 20 (2004) 1, S.36-42 (7 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2004.tb00005.x
Schlagwörter	Rural Areas; Cancer; Rural Urban Differences; Urban Areas; Females; Older Adults; Screening Tests; Kansas + Suchen Sie Ihr Suchwort? Rural area; Ländlicher Raum; Carcinoma; Karzinom; Krebs (med); Krebserkrankung; Stadt-Land-Beziehung; Urban area; Stadtregion; Weibliches Geschlecht; Älterer Erwachsener; Screening-Verfahren
Abstract	Breast cancer screening rates are lower in rural communities. Although studies have addressed barriers to mammography for rural residents, physician practice barriers have received less attention. Purpose: Controlled clinical trials have shown that the use of office reminder systems in primary care practices is related to increased clinical care rates. Therefore, we compared office systems use in primary care practices located in rural and urban communities and assessed the impact of these systems on rural-urban differences in mammography utilization. Methods: We identified female Kansas Medicare beneficiaries aged 65 to 79 from Medicare claims data (N = 24,030) and determined which beneficiaries received a mammogram between April 1, 1999, and March 31, 2001. We linked beneficiaries to their primary care providers and obtained surveys from 180 primary care practices on their use of office reminder systems. Findings: Mammography rates ranged from 20% to 92% (mean = 65%) among the 180 practices. Flowsheets with a mammography prompt were used by 33% of the practices, 38% utilized nonphysician staff to identify women due for mammograms, and 15% used computerized reminder systems. Urban practices used flowsheets more often than rural practices (44% versus 16%, P<0.001). A multivariable regression model demonstrated higher mammography rates in urban practices, group practices, and practices using mammography flowsheets. Conclusions: Despite success in randomized controlled trials, reminder systems are not used often by primary care providers and are used even less often in rural compared to urban practices. Consistent implementation may be a major barrier to the successful adaptation of flowsheets by primary care offices. (Author).
Anmerkungen	The Journal of Rural Health, Department of Family Medicine, U. B. Clinical Center 462 Grider Street, Buffalo, NY 14215. E-mail: ruralhealth@buffalo.edu.
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10