The Delivery of Clinical Preventive Services Acute Care Intervention

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Original Research

The Delivery of Clinical Preventive Services Acute Care Intervention

J Fam Pract. 1999 October;48(10):785-789

References

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We agree with Frame²⁰ that it is neither feasible nor necessary to insist that all patients schedule preventive visits to receive preventive care. The delivery of preventive services during acute care visits has been advocated as a necessary strategy to deliver adequate services to entire patient populations.^21,22 People want physicians to provide more preventive services,³² and many patients who have not scheduled preventive visits will accept them if the physician offers.^4,33 Preventive services delivery during illness visits is common in community practice,³³ though it is more prevalent in high-risk than average-risk patients.³⁴ Other primary care–based studies show that the best results are accomplished when these services are systematically offered to all patients during illness visits, regardless of risk status.^4,23,35,36 Offering preventive care during acute care visits can be integrated into office practice^4,33,34 and can be effective.^4,36

Conclusions

Coordinating efforts to offer evidence-based preventive services to all patients seen for acute care visits is a potential strategy to increase the delivery of this care. Implementation of this strategy could result in increased screening for patients enrolled in HMOs and for FFS patients with coverage. In 1996, Dean Health System began implementing a systemwide adult health maintenance guideline that emphasizes assessment and delivery during acute care visits and includes provider reports of guideline adherence. After 3 years of implementation, providers reported that more than 60,000 patients (mean = 1775 per month) were treated in accordance with the guideline. Follow-up audits are planned to monitor the outcome of this strategy to assess and offer preventive services during acute care visits.

Acknowledgments

We would like to thank Kurt C. Stange, MD, PhD, for constructive suggestions during the preparation of this manuscript, and Marcie Berger, MD; Jonathon Berkhoff, MD; Gene Bettinger; and Suzanne Hallett for technical assistance.