Improving Health in the Community A Role for Performance Monitoring (1997) / Chapter Skim
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A.1 Breast and Cervical Cancers
A.1 Breast and Cervical Cancers
Pages 189-204
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From page 189... ...
. Screening procedures such as clinical breast examination and mammography can help detect breast cancer at an early stage, which significantly increases chances for successful treatment and cure.
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From page 190... ...
. Identifying risk factors for breast cancer can provide some guidance for prioritizing screening and early intervention programs, but current screening guidelines rely primarily on age.
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From page 191... ...
Disease and Health Care Falling under the disease and health care domains of the field model are essential tasks for addressing breast and cervical cancer prevention. Currently, principal focus is on secondary prevention through screening programs.
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The qualifiers "affordable" and "quality controlled" were included to indicate that access is defined by certain expectations. Major stakeholders include health care providers, health plans, state health agencies, environmental health agencies, and communitybased organizations.
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From page 193... ...
For women who have been screened, follow-up by health care providers and health plans of the results and recommendations from screening programs is essential to early intervention in the event of disease or evidence of high risk of disease. Local public health agencies are another important stakeholder; they may coordinate tracking programs that remind women about screening or may follow up women who are in need of care and lost to the system.
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From page 194... ...
Benefits conferred by changing these behaviors will extend well beyond a decreased risk of cervical cancer; risks of sexually transmitted diseases, lung disease, and unwanted pregnancy will also be reduced. Fewer of the risk factors for breast cancer are modifiable.
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Public education programs involve all stakeholders. Health care providers and health plans often are a source of education for patients.
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In response to the American Cancer Society (1989) report Cancer and the Poor, hospitals that serve poor patients began to respond to their special needs (e.g., diagnosis at a later stage of disease, lack of insurance, unfamiliarity with negotiating the health care system)
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From page 197... ...
Measuring access, quality, and barriers will require cooperation among health care providers including health plans, hospitals, and individual clinicians, public health agencies, and the insurance industry. Questions about access are available in the Behavioral Risk Factor Surveillance System (BRFSS)
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From page 198... ...
Examples of performance indicators that could be used in communities include the following: • For each health plan or insurer, the proportion of enrolled women who should have breast and cervical cancer screening who received appropriate screening services in the past 12 months. • For women who are not enrolled in a health plan or insur
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From page 199... ...
Some of these data are tracked by state health departments and health plans. The following are examples of performance indicators that could be used in communities: • Proportion of employers, community-based organizations, school PTAs, or faith organizations that provided in the past 12 months health promotion programs in the community about the value of screening, breast self-exam, and the availability of screening programs to prevent breast and cervical cancer among women.
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Journal of the American Medical Association 270:1563–1568.
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1994. The Washington State Public Health Improvement Plan.
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, and pelvic examination: Proportion and number of facilities offering mammography and Pap tests that meet federal and state regulatory standards. Proportion of health plans or insurers that cover 80 percent or more of the cost of breast and cervical cancer screening.
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From page 203... ...
Behavior, Behaviors that reduce Rates of tobacco use and alcohol consumption BRFSS Genetic risk and promote health among women Endowment A.1 BREAST AND CERVICAL CANCERS Proportion of sexually active women who use Community survey, review barrier methods of contraception of medical records Utilization of screening programs by women at HEDIS or BRFSS risk for breast and cervical cancer: For each health plan or insurer, proportion of enrolled women who should have breast and cervical cancer screening who received appropriate services in the past 12 months. For women who are not enrolled in a health plan or insurance group, proportion who should have breast and cervical cancer screening who received appropriate screening services in the past 12 months.
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From page 204... ...
NOTE: BRFSS, Behavioral Risk Factor Surveillance System; HEDIS, Health Plan Employer Data and Information Set; MCO, managed care organization; PTA, parent–teacher association.
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