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J Gen Intern Med. 1989 Sep-Oct;4(5):403-9.

A controlled trial to improve delivery of preventive care: physician or patient reminders?

Author information

  • 1Department of Medicine, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA.

Abstract

OBJECTIVE:

To improve the delivery of preventive care in a medical clinic, a controlled trial was conducted of two interventions that were expected to influence delivery of preventive services differently, depending on level of initiative required of the physician or patient to complete a service.

DESIGN:

A prospective, controlled trial of five-months' duration.

SETTING:

A university hospital-based, general medical clinic.

PARTICIPANTS:

Thirty-nine junior and senior medical residents who saw patients in stable clinic teams throughout the study.

INTERVENTION:

A computerized reminder system for physicians and a patient questionnaire and educational hand-out on preventive care.

MEASUREMENTS AND MAIN RESULTS:

Delivery of five of six audited preventive services improved significantly after the interventions were introduced. The computerized reminder alone increased completion rates of services that relied primarily on physician initiative; the questionnaire alone increased completion rate of the service that depended more on patient compliance as well as on some physician-dependent services. Both interventions used together were slightly less effective in improving performance of physician-dependent services than the computerized reminder used alone.

CONCLUSIONS:

These interventions can improve the delivery of preventive care but they differ in their impacts on physician and patient behaviors. Overall, the computer reminder was the more effective intervention.

PMID:
2677271
[PubMed - indexed for MEDLINE]
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