Korean Journal of Health Education and Promotion (보건교육건강증진학회지)

Korean Society for Health Education and Promotion (한국보건교육건강증진학회)
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Effect of healthcare access and healthcare provider status on recommendation for Pap test among Korean American women in Alameda and Santa Clam Counties, California

미국 캘리포니아주에 거주하는 한인여성들의 자궁경부암 수검권고에 영향을 미치는 보건의료 접근성 및 보건의료인의 특성 분석

  • Kim, Young-Bok (Department of Health Administration, College of Health Science, Seonam University)
  • Published : 2008.12.30
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Abstract

Purpose: Recommendation for regular Pap test in the past 3 years as a cue to action affects on an increased likelihood of receiving a cervical cancer screening in that period. This study performed to estimate the association with healthcare access, healthcare provider status, and physician recommendation for Pap test in the past 3 years among Korean American women. Method: Korean Health survey was carried out in 2002. These population-based telephone surveys were conducted with Korean American women who resided in Alameda and Santa Clara Counties, California (n=865). We preformed multiple logistic regression analyses to estimate predictors of physician recommendation for Pap test by SAS 8.2. Results: Korean women in two California Counties were 37.9% who received physician recommendation for Pap test in the past 3 years. The predictors on physician recommendation for Pap test in the past 3 years were health insurance coverage, visiting number to doctor in the past year, and healthcare provider status. For healthcare access, no matter who had enrolled in public or private health insurances, the women were more likely to get the recommendation for Pap test from their regular healthcare provider. Particularly, for ethnicity of healthcare provider, the women were more likely to get the recommendation for Pap test from non-Korean female doctors (OR=6.21, 95% CI=2.63, 14.66), Korean male doctors (OR=2.19, 95% CI=1.30, 3.68), and non-Korean male doctors (OR=2.07, 95% CI=1.15, 3.71). Conclusion: (삭제) Effect of healthcare access and healthcare provider status on recommendation for Pap test among Korean American women in two California Counties would contribute to our understanding of developing strategies to promote adherence of Pap test and reduce morbidity and mortality far cervical cancer among Korean American women in the U.S.

연구목적: 3년마다 정기적인 자궁경부암 조기검진을 받도록 권고하고 있는 수검권고안은 검진행동 유발요인으로써 자궁경부암 검진참여의 가능성을 증진시키는 주요 영향요인으로 작용하고 있다. 본 연구는 보건의료 접근성과 보건의료인의 특성이 자궁경부암 조기검진 수검권고에 미치는 영향을 살펴보고자 시도되었다. 연구방법: 본 연구에서 재분석된 한인여성 건강조사자료는 미국 캘리포니아주 알라메다와 산타클라라 카운티에 거주하는 한인여성 865명을 대상으로 2002년에 전화설문조사로 수행되었다. 수검권고안에 영향을 미치는 주요 예측인자를 살펴보기 위해 로지스틱 회귀분석을 수행하였다. 연구결과: 조사대상자 중 37.9%만이 지난 3년간 자궁경부암 조기검진 참여에 관한 수검권고를 받은 것으로 나타났다. 수검권고의 주요 예측인자는 건강보험 가입여부, 지난 1년간의 의사방문횟수, 정기적으로 방문하는 보건의료인의 특성인 것으로 나타났다. 또한 보건의료 접근성에서는 공공의료보험 또는 사보험 여부와 관계없이 건강보험에 가입한 여성들이 수검권고를 더 많이 받은 것으로 나타났다. 특히 보건의료인의 특성 중 인종과의 관련성을 살펴보면, 한인이 아닌 타 인종의 여성 의사로부터 가장 많이 검진참여에 관한 수검권고를 받았고(OR=6.21, 95% CI=2.63, 14.66), 다음으로 한인 남성 의사(OR=2.19, 95% CI=1.30, 3.68), 비한인 남성 의사로부터 수검권고를많이 받았다(OR=2.07, 95% CI=1.15, 3.71). 결론: 캘리포니아주의 2개 카운티에서 거주하는 한인여성을 대상으로 보건의료 접근성과 보건의료인의 특성이 자궁경부암 조기검진 수검권고에 미치는 영향을 분석한 결과, 한인여성들의 건강보험 가입여부 및 의사방문 수준, 보건의료인의 인종이 수검권고와 관련이 있는 것으로 나타났다. 이는 한인여성들의 자궁경부암 조기검진 수검률 향상 및 자궁경부암 이환률과 사망률을 감소시키기 위한 수행전략 개발에 중요한 기초자료로 활용될 수 있다.

Keywords

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