Bthm. Palm et al., THE EFFECT OF THE FAMILY PHYSICIAN ON IMPROVING FOLLOW-UP AFTER AN ABNORMAL PAP SMEAR, International journal for quality in health care, 9(4), 1997, pp. 277-282
Objective: The aim of this study was to assess the effect of the famil
y physician on improving compliance with follow-up of abnormal smears
in cervical cancer screening. Design: Observational study. Setting: Tw
o Regional Health Authority districts in the east of The Netherlands.
Study participants: Family practices with a national call system for c
ervical cancer screening and family practices with a family-practice-b
ased calf system. In a number of practices the family physicians had i
ntroduced a fail-safe system for follow-up. Main outcome measures: Fol
low-up of women who participated in the first screening round and in w
hom a cytological abnormality had been diagnosed in the first smear. C
riteria for adequate follow-up were defined with regard to the severit
y of the cytological abnormality. Results: The overall compliance with
follow-up in the study-group was 88%. The study showed a strong relat
ionship between involvement of the family physician and compliance wit
h follow-up. The compliance in practices that had a fail-safe system f
or follow-up was 93% compared to 82% in the practices without a fail-s
afe system. The highest follow-up was found in practices involved in t
he family-practice-based system, (C) 1997 Elsevier Science Ltd.