Premium
Results of a randomized controlled trial to increase colorectal cancer screening in a managed care health plan
Author(s) -
Ganz Patricia A.,
Farmer Melissa M.,
Belman Michael J.,
Garcia Christine A.,
Streja Leanne,
Dietrich Allen J.,
Winchell Charlotte,
Bastani Roshan,
Kahn Katherine L.
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21434
Subject(s) - medicine , randomized controlled trial , colorectal cancer , cancer screening , cancer , intervention (counseling) , health care , physical therapy , family medicine , nursing , economics , economic growth
BACKGROUND Colorectal cancer (CRC) is the third most common cause of cancer deaths; however, rates of regular screening for this cancer are low. A quality improvement (QI) program to increase CRC screening was developed for use in a managed care health plan. METHODS Thirty‐six provider organizations (POs) contracting with the health plan were recruited for a randomized controlled effectiveness trial testing the QI program. The intervention was delivered over a 2‐year period, and its effectiveness was assessed by chart review of a random sample of patients from each PO. RESULTS Thirty‐two of the 36 POs were evaluable for outcome assessment. During the 2‐year intervention period, only 26% of the eligible patients received any CRC screening test. Twenty‐nine percent of patients had any CRC screening test within guidelines, with no differences between the intervention or control POs. Significant predictors of having received CRC screening within guidelines were older age ( P = 0.0004), receiving care in an integrated medical group ( P < 0.0001) and having had a physical examination within the past 2 years ( P < 0.0001). CONCLUSIONS A facilitated QI intervention program for CRC screening that focused on the PO did not increase rates of CRC screening. Overall CRC screening rates are low and are in need of improvement. Cancer 2005. © 2005 American Cancer Society.