Percentage of Up-to-Date Preventive Services at Baseline, 4 Months, and 16 Months Postintervention
| Control Population (n = 2,250) | Intervention Population (n = 2,250) | Intervention Population Subgroup Analysis | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Nonusers (n = 1,872) | Users (n = 378) | |||||||||||
| Indicated Preventive Services | Baseline | 4 mo | 16 mo | Baseline | 4 mo | 16 mo | Baseline | 4 mo | 16 mo | Baseline | 4 mo | 16 mo |
| Overall delivery of indicated preventive services | ||||||||||||
| Patients up-to-date on all indicated services (all-or-none measure) | 11.1 | 12.1 | 12.6 | 11.4 | 13.5a,b | 15.2b,c | 11.7 | 13.4 | 13.9b,d | 13.6 | 17.8 | 25.1b,c |
| Percentage of up-to- date services (composite measure) | 61.4 | 62.1 | 59.2c,e | 61.7 | 63.1b,d | 60.4 | 60.9 | 61.5 | 58.5a,e | 64.9 | 70.1b,c | 69.4a,b |
| Delivery of specific preventive services | ||||||||||||
| Colorectal cancer screening | 36.8 | 40.4 | 43.9b,d | 37.7 | 45.2a,b | 47.8b,c | 40.0 | 43.9 | 46.6a,b | 53.0 | 72.2a,b | 73.9b,c |
| Breast cancer screening | 44.1 | 53.2b,d | 29.6c,e | 52.4 | 58.5 | 35.8c,e | 52.9 | 55.7 | 36.2c,e | 75.1 | 90.1b,d | 66.1 |
| Cervical cancer screening | 67.6 | 71.8 | 68.4 | 72.7 | 74.9 | 73.3 | 71.5 | 72.0 | 71.0 | 79.5 | 91.2a,b | 92.4a,b |
| Prostate cancer screening | 56.8 | 46.5c,e | 48.9a,e | 50.8 | 48.5 | 52.3 | 47.0 | 46.2 | 52.0 | 71.8 | 65.0 | 62.0 |
| Hypertension screening | 99.9 | 98.1c,e | 93.0c,e | 100.0 | 98.6c,e | 92.8c,e | 99.9 | 94.5c,e | 79.9c,e | 100.0 | 99.5 | 96.6c,e |
| Hypercholesterolemia screening | 82.8 | 86.0a,b | 85.9b,d | 80.7 | 83.2 b,d | 85.2b,c | 79.7 | 82.1 | 84.5b,c | 91.1 | 93.2 | 93.3 |
| Abdominal aortic aneurysm screening | 24.0 | 22.7 | 25.3 | 24.6 | 23.7 | 25.4 | 28.5 | 22.7 | 22.6 | 15.4 | 25.9 | 32.1 |
| Diabetes screening | 77.1 | 80.6 | 82.0a,b | 74.9 | 81.3a,b | 84.5b,c | 76.1 | 82.6a,b | 84.9b,c | 87.9 | 90.6 | 96.7a,b |
| Chlamydia screening | 21.1 | 10.2 | 21.7 | 17.8 | 10.0 | 21.3 | – | – | – | – | – | – |
| Osteoporosis screening | 39.7 | 41.9 | 48.5 | 45.2 | 51.1 | 57.9b,d | 38.2 | 41.0 | 51.7b,d | 72.0 | 90.6 | 96.3 |
| Aspirin chemoprophylaxis use | 53.1 | 58.9 | 58.8 | 61.0 | 56.8 | 57.6 | 61.8 | 56.7 | 55.5 | 58.3 | 57.1 | 64.8 |
| Tetanus immunization | 46.9 | 52.3a,b | 51.4a,b | 46.4 | 52.8b,c | 52.8b,c | 51.1 | 55.7a,b | 55.7a,b | 57.6 | 70.9a,b | 72.6b,c |
| Influenza immunization | 30.7 | 28.6 | 27.5 | 29.6 | 30.3 | 30.6 | 29.2 | 28.8 | 29.6 | 37.3 | 42.1 | 40.7 |
| Pneumococcal immunization | 22.5 | 27.8a,b | 30.9b,c | 20.8 | 28.9b,c | 34.9b,c | 25.2 | 33.2a,b | 39.3b,c | 48.2 | 62.4a,b | 71.1b,c |
| Smoking cessation counseling | 80.1 | 80.2 | 71.5 | 70.1 | 75.0 | 73.7 | 69.7 | 79.5 | 78.2 | 70.4 | 62.4 | 54.0 |
| Dietary counseling | 15.0 | 17.3 | 14.7 | 16.1 | 17.8 | 17.5 | 15.7 | 18.4 | 17.6 | 16.5 | 15.7 | 17.0 |
| Exercise counseling | 18.8 | 16.2 | 18.2 | 18.8 | 20.2 | 18.5 | 18.1 | 19.3 | 18.0 | 19.5 | 21.5 | 18.4 |
| Weight loss counseling | 51.8 | 53.1 | 47.9 | 51.1 | 48.5 | 46.1 | 56.1 | 54.0 | 49.6 | 47.0 | 40.7 | 47.0 |
Notes: All values adjusted for age, sex, practice location, and survey response, except abdominal aortic aneurysm screening, Chlamydia screening, and aspirin chemoprophylaxis use, for which sample sizes were too small for adjusting (ie, these values are unadjusted). P values compare the 4-month or the 16-month up-to-date value with the baseline up-to-date value.
↵a P <.02.
↵b Statistically significant increase in service delivery.
↵c P <.001.
↵d P <.05.
↵e Statistically significant decrease in service delivery.