BACKGROUND:A large insurer in Hawaii mails annual reminders to its members regarding recommended health screenings. This study examined the associations between the characteristics of physicians visited after the reminders were sent and the health screenings received for breast, cervical, and colorectal cancers, and for diabetes and cholesterol. METHODS:The study population included members identified as needing health screenings from 2000 to 2003 based on age and gender criteria. The study used a longitudinal design focusing on the 12 months after reminders were sent. Data were analyzed using logistic regression examining physician visits, other health services, and receipt of health screenings by 1-month intervals subsequent to the reminder mailings. RESULTS:In adjusted, multivariable models, members who saw physicians they had not seen in the past year had odds ratios for obtaining health screenings 6 to 8 times higher than members who only saw previously visited physicians. This enhanced response occurred among members receiving their first, second, and third (or subsequent) annual reminder letter. The more physicians that were visited and who were new to the members, the more likely the members were to obtain health screenings. CONCLUSIONS:Members seeing physicians they had not seen in the past year had significantly higher screening rates than the members only seeing physicians they had previously visited. The results suggest that healthcare screening may receive less attention at repeat visits with a physician than at visits with a physician who is new to a member.

译文

背景:夏威夷的一家大型保险公司向其会员发送有关建议的健康检查的年度提醒。这项研究检查了在发出提醒后拜访的医生的特征与接受的针对乳腺癌,宫颈癌和结肠直肠癌以及糖尿病和胆固醇的健康检查之间的关联。
方法:研究人群包括根据年龄和性别标准从2000年至2003年被确定需要进行健康检查的成员。该研究使用了纵向设计,重点是在发送提醒后的12个月。使用Logistic回归分析数据,检查提示性邮件之后的1个月间隔,检查医师就诊,其他健康服务以及接受健康检查的时间。
结果:在经过调整的多变量模型中,过去一年没有看过医生的会员获得健康检查的几率比只看过以前看过的医生的会员高6至8倍。收到第一,第二和第三(或后续)年度提醒函的会员之间反应更加强烈。拜访的医生越多且对成员来说是新手,则成员进行健康检查的可能性就越大。
结论:过去一年没有看过医生的会员的筛查率比以前只看过医生的会员要高得多。结果表明,与反复接触某位成员的医生相比,对医生的反复访问对医疗保健筛查的关注较少。

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