Continuity of care and colorectal cancer screening by Vietnamese American patients.
BACKGROUND
Colorectal cancer (CRC) screening rates among Asian Americans are 30-50% lower than among Whites. Using practice management and electronic medical records data from a community health center, we examined the association of CRC screening with continuity of care and comorbidity. These variables have not previously been studied in Asian American and limited-English proficient populations.


METHODS
After obtaining IRB approval, we extracted data in 2009 on age-eligible Vietnamese patients who had one or more clinic visits in the prior 24 months. Our analysis examined associations between CRC screening (per current US Preventive Services Task Force guidelines) and clinic site, demographics, insurance status, continuity of care, comorbidities, and provider characteristics.


RESULTS
We identified a total of 1,016 eligible patients (604 at Clinic 1 and 412 at Clinic 2). Adherence to CRC screening was lower for patients who were male; lacked insurance; had only one medical visit in the past 12 months; and had no assigned primary care provider. Our multivariable models showed higher screening rates among patients who were female; had public health insurance; and had more than one medical visit in the past 12 months, regardless of high or low continuity of care.


CONCLUSIONS
We found no association between higher continuity of care and CRC screening. Additional primary care systems research is needed to guide cancer screening interventions for limited-English proficient patients.
Department of Medicine, University of Washington, Seattle, WA, USA. shinping@u.washington.edu
Shin-Ping
SP
Tu
Mei-Po
MP
Yip
Lin
L
Li
Alan
A
Chun
Vicky
V
Taylor
Yutaka
Y
Yasui
D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003710:Demography; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007802:Language; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D014744:Vietnam / Q000208:ethnology