Document Detail


Uptake of cervical screening in general practice: effect of practice organisation, structure, and deprivation.
MedLine Citation:
PMID:  8861049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES - To investigate associations between uptake for cervical screening in general practice and the organisation of screening, features of practice structure, and deprivation. SETTING - Greater Glasgow Health Board area in the west of Scotland, which covers a socioeconomically varied population. METHODS - General practice questionnaire survey and interview based study. The main outcome measure was the uptake rate for each participating practice over the five and a half years ending 31 December 1993. This was used to determine whether practices achieved 80% uptake to trigger maximum payment for cervical screening services. RESULTS - Forty seven percent (n = 92) of all practices in the Greater Glasgow Health Board area agreed to take part in the research, with complete data collected for 87 practices. Participation varied according to number of partners in the practice and the average deprivation score of the practice. Uptake rates ranged from 48-2% to 92-9% (median 77.5%, interquartile range 69.8% to 83.4%). Thirty seven practices (43%) achieved the 80% target. None of the recommended features of good organisation of cervical screening showed any statistically significant association with uptake rates. In stepwise multiple regression four variables were shown to have independent associations with uptake. These were the number of partners in the practice, the average deprivation of the practice, the presence of a female general practitioner, and using a practice's own lists for sending out letters of invitation. In stepwise logistic regression just two of these variables contributed to the prediction of achieving 80% uptake namely, average deprivation and number of partners. There were no significant interactions between deprivation and the organisation of screening in relation to uptake. CONCLUSIONS - Organising cervical screening in general practice according to accepted standards is less important in predicting uptake than more intractable features of the practice such as the size of the partnership, its average deprivation level, the presence of a female general practitioner, and using their own (presumed more accurate) register of addresses to call women. A flexible incentive scheme may more fairly reward the efforts of those general practitioners who achieve high uptake rates but who do not trigger remuneration at the 80% level.
Authors:
T Ibbotson; S Wyke; J McEwen; S Macintyre; M Kelly
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of medical screening     Volume:  3     ISSN:  0969-1413     ISO Abbreviation:  J Med Screen     Publication Date:  1996  
Date Detail:
Created Date:  1997-02-27     Completed Date:  1997-02-27     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9433359     Medline TA:  J Med Screen     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  35-9     Citation Subset:  IM    
Affiliation:
Health Services Research Unit, University of Aberdeen, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Family Practice / manpower,  organization & administration*,  statistics & numerical data
Female
Humans
Mass Screening / organization & administration*,  statistics & numerical data*
Multivariate Analysis
Questionnaires
Scotland
Socioeconomic Factors*
Uterine Cervical Diseases / prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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