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背景对影响健康的社会因素的调查研究可以帮助基层医疗在实践中做出针对性的改进,但此方面的数据目前甚少。位于安大略省多伦多市的全科诊所,全科医生们使用多机构委员会研制的试点调查方案在患者中定期开展调查,从而获得了患者的社会人口学资料。目的是使用这些资料来探究影响健康的社会因素与结直肠癌、宫颈癌和乳腺癌筛查之间的关系,以及阐明使用自行在患者中开展的调查获得的数据进行研究所面临的机遇与挑战。方法选取至少做过结直肠癌、宫颈癌和乳腺癌三项筛查之一(年龄的计算及筛查指南有效性均截至2015-06-30),并且在社会人口学调查中至少回答了一个问题的患者为研究对象。调查地点为本全科诊所。分析患者的社会人口学资料及其电子病历与癌症筛查记录。结果共调查患者5 766例。这些患者行3种癌症筛查的比例分别高于未参与此项调查的患者(13 036例)〔结直肠癌筛查比例(72.9%与59.2%)、宫颈癌筛查比例(78.7%与65.3%)、乳腺癌筛查比例(74.4%与58.9%)〕。加拿大以外国家出生的患者结直肠癌筛查主动性高于加拿大本土出生的患者,但是其在另外两种癌症筛查方面没有差异。家庭最低收入标准与行癌症筛查比例有联系。居民收入五分位数与行癌症筛查患者比例无关联。住房状况与癌症筛查比例有关联。结论不同患者行癌症筛查比例差异与居民收入五分位数无关联,与个人收入有关联,但个人收入相关资料的收集却有很大的难度。未来此项研究将着重于如何降低因为收入而造成的此种差异的程度,同时探究怎样能最好地收集患者在社会经济学方面的资料。
Background Research on the social factors that affect health can help primary care to make targeted improvements in practice, but the data in this area are very few at present. At the General Practice Clinic in Toronto, Ontario, GPs conducted routine demographic surveys in their patients using a pilot survey program developed by the multi-agency committee to obtain patient demographic information. The purpose is to use this information to explore the relationship between health-affecting social factors and colorectal, cervical and breast cancer screening, as well as to identify opportunities and challenges in conducting research using data obtained from surveys conducted in patients themselves . METHODS: We selected at least one of three screening tests for colorectal cancer, cervical cancer and breast cancer (age validation and screening guidelines were valid as of 2015-06-30) and at least one of them was answered in the sociodemographic survey The problem patient is the subject of study. The survey site-based general practice clinic. Analysis of the patient’s socio-demographic data and its electronic medical records and cancer screening records. Results A total of 5 766 patients were investigated. The proportion of these 3 cancer screening patients in these patients was higher than that of those who did not participate in the survey (13 036 cases) (72.9% vs. 59.2% for colorectal cancer screening, 78.7% vs 65.3 for cervical cancer screening %), Breast cancer screening ratio (74.4% and 58.9%)]. Patients born outside Canada were more likely to have colorectal cancer screening than those born in Canada, but there was no difference in the other two cancer screening. The minimum family income is linked to the proportion of cancer screening. Household income quintile has no correlation with the proportion of cancer screening patients. Housing status is linked to cancer screening rates. Conclusion There is no correlation between the proportion of cancer screening among different patients and the quintile of household income, which is related to personal income. However, it is very difficult to collect personal income related information. In the future, this study will focus on how to reduce the level of such differences as a result of income while exploring ways to best collect patient socio-economic information.