Pap Recency: Modeling Women′s Characteristics and Their Patterns of Medical Care Use

Background. Medical care use was identified as an important predictor of Pap smear use in previous studies. This study scrutinized several dimensions of women′s patterns of medical care use in relation to Pap smear use. Methods. Cross-sectional national household survey data were linked to the respondents′ Quebec Medicare records for a 3-year period. Factors associated with the recency of the reported last Pap were analyzed in a subsample of women ages 18-35 years (n = 1,799) by logistic ordinal regression. The resulting models were tested in a confirmatory sample (n = 1,799). Results. Three dimensions of medical care use were examined while adjusting for women′s characteristics. Recency of testing was associated with the volume of ambulatory visits to general practitioners and to obstetrician-gynecologists, with the regularity of care, and with the number of different physicians visited. Conclusions. Women′s pattern of medical care use, especially the regularity of care, was an important predictor of Pap recency. Results suggest targets for improvement of screening coverage and highlight the critical role of general practitioners.