Delivery rates for preventive services in 44 midwestern clinics

Thomas E. Kottke; Leif I. Solberg; Milo L. Brekke; Antonio Cabrera; Miriam A. Marquez

doi:10.4065/72.6.515

Delivery rates for preventive services in 44 midwestern clinics

Thomas E. Kottke
, Leif I. Solberg
, Milo L. Brekke
, Antonio Cabrera
, Miriam A. Marquez

Research output: Contribution to journal › Article › peer-review

78 Scopus citations

Abstract

Objective: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations. Material and Methods: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4%)completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit. Results: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33%). Except for blood pressure and smoking cessation advice, less than 30% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important. Conclusion: Preventive services consensus goals are not being met, even for patients who report thai their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.

Original language	English (US)
Pages (from-to)	515-523
Number of pages	9
Journal	Mayo Clinic Proceedings
Volume	72
Issue number	6
DOIs	https://doi.org/10.4065/72.6.515
State	Published - 1997

Bibliographical note

Funding Information:
We also gratefully acknowledge the support of the sponsoring health maintenance organizations (Blue Plus and HealthPartners), Group Health Foundation, and the rest of the IMPROVE project staff. Overall, however, much of whatever success this project achieves will be the result of the voluntary efforts of the participating clinics and their staffs: HealthPartners St. Paul Clinic, Kasson Mayo Family Practice Clinic, Aspen Medical Group-Bloomington, East Main Physicians, East Side Medical Center, Family Medical Center-Hennepin County, Forest Lake Doctors Clinic, Hudson Physicians, North Clinic, Northport Medical Center, Palen Heights Medical Center, Ramsey Clinic–Osceola, Ramsey Family Physicians, Richfield Medical Group, River Valley-Cottage Grove, River Valley-Hastings, River Valley-Woodbury, River Valley Medical Center-St. Croix Falls, Silver Lake Clinic, Southdale Internal Medicine, Southwest Clinic, St. Croix Valley Clinic, Sundance Medical Center, Valley Family Practice, Apple Valley Medical Center, Aspen Medical Group–W. St. Paul, Aspen Medical Group–W. Suburban, Chanhassen Medical Center, Chisago Medical Center, Creekside Family Practice, Douglas Drive Family Physicians, Eagle Medical, Fridley Medi cal Center, Hastings Family Practice, Hopkins Family Practice, Interstate Medical Center, Metropolitan Internists, Mork Clinic-Anoka, North St. Paul Medical Center, Ramsey Clinic–Amery, Ramsey Clinic–Baldwin, River Valley Clinic–Farmington, River Valley Clinic–Northfield, Southdale Family Practice, Stillwater Clinic, and United Family Medical Center.

Funding Information:
IMPROVE is an investigator-initiated randomized controlled trial. Funded by a grant from the Agency for Health Care Policy and Research, it is sponsored by two large Minnesota managed-care organizations (HealthPartners and Blue Plus) with participation by investigators at Mayo Clinic Rochester. The primary hypothesis of the project is that managed-care organizations can improve the delivery rates of preventive services by teaching clinics to apply continuous quality improvement to the task of developing preventive services delivery systems. The hypothesis is being tested in a volunteer sample of 22 randomly assigned matched pairs of private, primary-care clinics that are located in or within 50 miles of the metropolitan area of Minneapolis-St. Paul and contract with one or both of the two managed-care organizations.

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title = "Delivery rates for preventive services in 44 midwestern clinics",

abstract = "Objective: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations. Material and Methods: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4\%)completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit. Results: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33\%). Except for blood pressure and smoking cessation advice, less than 30\% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50\% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important. Conclusion: Preventive services consensus goals are not being met, even for patients who report thai their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.",

author = "Kottke, \{Thomas E.\} and Solberg, \{Leif I.\} and Brekke, \{Milo L.\} and Antonio Cabrera and Marquez, \{Miriam A.\}",

note = "Funding Information: We also gratefully acknowledge the support of the sponsoring health maintenance organizations (Blue Plus and HealthPartners), Group Health Foundation, and the rest of the IMPROVE project staff. Overall, however, much of whatever success this project achieves will be the result of the voluntary efforts of the participating clinics and their staffs: HealthPartners St. Paul Clinic, Kasson Mayo Family Practice Clinic, Aspen Medical Group-Bloomington, East Main Physicians, East Side Medical Center, Family Medical Center-Hennepin County, Forest Lake Doctors Clinic, Hudson Physicians, North Clinic, Northport Medical Center, Palen Heights Medical Center, Ramsey Clinic{\textendash}Osceola, Ramsey Family Physicians, Richfield Medical Group, River Valley-Cottage Grove, River Valley-Hastings, River Valley-Woodbury, River Valley Medical Center-St. Croix Falls, Silver Lake Clinic, Southdale Internal Medicine, Southwest Clinic, St. Croix Valley Clinic, Sundance Medical Center, Valley Family Practice, Apple Valley Medical Center, Aspen Medical Group{\textendash}W. St. Paul, Aspen Medical Group{\textendash}W. Suburban, Chanhassen Medical Center, Chisago Medical Center, Creekside Family Practice, Douglas Drive Family Physicians, Eagle Medical, Fridley Medi cal Center, Hastings Family Practice, Hopkins Family Practice, Interstate Medical Center, Metropolitan Internists, Mork Clinic-Anoka, North St. Paul Medical Center, Ramsey Clinic{\textendash}Amery, Ramsey Clinic{\textendash}Baldwin, River Valley Clinic{\textendash}Farmington, River Valley Clinic{\textendash}Northfield, Southdale Family Practice, Stillwater Clinic, and United Family Medical Center. Funding Information: IMPROVE is an investigator-initiated randomized controlled trial. Funded by a grant from the Agency for Health Care Policy and Research, it is sponsored by two large Minnesota managed-care organizations (HealthPartners and Blue Plus) with participation by investigators at Mayo Clinic Rochester. The primary hypothesis of the project is that managed-care organizations can improve the delivery rates of preventive services by teaching clinics to apply continuous quality improvement to the task of developing preventive services delivery systems. The hypothesis is being tested in a volunteer sample of 22 randomly assigned matched pairs of private, primary-care clinics that are located in or within 50 miles of the metropolitan area of Minneapolis-St. Paul and contract with one or both of the two managed-care organizations. ",

year = "1997",

doi = "10.4065/72.6.515",

language = "English (US)",

volume = "72",

pages = "515--523",

journal = "Mayo Clinic Proceedings",

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T1 - Delivery rates for preventive services in 44 midwestern clinics

AU - Kottke, Thomas E.

AU - Solberg, Leif I.

AU - Brekke, Milo L.

AU - Cabrera, Antonio

AU - Marquez, Miriam A.

N1 - Funding Information: We also gratefully acknowledge the support of the sponsoring health maintenance organizations (Blue Plus and HealthPartners), Group Health Foundation, and the rest of the IMPROVE project staff. Overall, however, much of whatever success this project achieves will be the result of the voluntary efforts of the participating clinics and their staffs: HealthPartners St. Paul Clinic, Kasson Mayo Family Practice Clinic, Aspen Medical Group-Bloomington, East Main Physicians, East Side Medical Center, Family Medical Center-Hennepin County, Forest Lake Doctors Clinic, Hudson Physicians, North Clinic, Northport Medical Center, Palen Heights Medical Center, Ramsey Clinic–Osceola, Ramsey Family Physicians, Richfield Medical Group, River Valley-Cottage Grove, River Valley-Hastings, River Valley-Woodbury, River Valley Medical Center-St. Croix Falls, Silver Lake Clinic, Southdale Internal Medicine, Southwest Clinic, St. Croix Valley Clinic, Sundance Medical Center, Valley Family Practice, Apple Valley Medical Center, Aspen Medical Group–W. St. Paul, Aspen Medical Group–W. Suburban, Chanhassen Medical Center, Chisago Medical Center, Creekside Family Practice, Douglas Drive Family Physicians, Eagle Medical, Fridley Medi cal Center, Hastings Family Practice, Hopkins Family Practice, Interstate Medical Center, Metropolitan Internists, Mork Clinic-Anoka, North St. Paul Medical Center, Ramsey Clinic–Amery, Ramsey Clinic–Baldwin, River Valley Clinic–Farmington, River Valley Clinic–Northfield, Southdale Family Practice, Stillwater Clinic, and United Family Medical Center. Funding Information: IMPROVE is an investigator-initiated randomized controlled trial. Funded by a grant from the Agency for Health Care Policy and Research, it is sponsored by two large Minnesota managed-care organizations (HealthPartners and Blue Plus) with participation by investigators at Mayo Clinic Rochester. The primary hypothesis of the project is that managed-care organizations can improve the delivery rates of preventive services by teaching clinics to apply continuous quality improvement to the task of developing preventive services delivery systems. The hypothesis is being tested in a volunteer sample of 22 randomly assigned matched pairs of private, primary-care clinics that are located in or within 50 miles of the metropolitan area of Minneapolis-St. Paul and contract with one or both of the two managed-care organizations.

PY - 1997

Y1 - 1997

N2 - Objective: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations. Material and Methods: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4%)completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit. Results: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33%). Except for blood pressure and smoking cessation advice, less than 30% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important. Conclusion: Preventive services consensus goals are not being met, even for patients who report thai their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.

AB - Objective: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations. Material and Methods: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4%)completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit. Results: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33%). Except for blood pressure and smoking cessation advice, less than 30% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important. Conclusion: Preventive services consensus goals are not being met, even for patients who report thai their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.

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Delivery rates for preventive services in 44 midwestern clinics

Abstract

Bibliographical note

UN SDGs

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