Skip to main content
Log in

Primary care and receipt of preventive services

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: To examine whether health insurance, a regular place of care, and optimal primary care are independently associated with receiving preventive care services.

DESIGN: A cross-sectional telephone survey.

SETTING: Population based.

PARTICIPANTS: Probability sample of 3,846 English-speaking and Spanish-speaking women between the ages of 18 and 64 in urban California.

INTERVENTIONS: Women were asked about their demographic characteristics, financial status, health insurance status, need for ongoing care, regular place of care, and receipt of blood pressure screening, clinical breast examinations, mammograms, and Pap smears. Women who reported a regular place of care were asked about four components of primary care: availability, continuity, comprehensiveness, and communication.

MEASUREMENTS AND MAIN RESULTS: In multivariate analyses that controlled for differences in demographics, financial status, and need for ongoing care, having a regular place of care was the most important factor associated with receiving preventive care services (p<.0001). Having health insurance (p<.001) and receiving optimal primary care from the regular place of care (p<.01) further significantly increased the likelihood of receiving preventive care services.

CONCLUSION: A regular source of care is the single most important factor associated with the receipt of preventive services, but optimal primary care from a regular place increases the likelihood that women will receive preventive care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Benson P, Gabriel A, Katz H, Steinwachs D, Hankin J, Starfield B. Preventive care and overall use of services: Are they related? Am J Dis Child. 1984;138:74–8.

    PubMed  CAS  Google Scholar 

  2. Charney E, Bynum R, Eldredge D, et al. How well do patients take oral penicillin? A collaborative study in private practice. Pediatrics. 1967;40:188–95.

    PubMed  CAS  Google Scholar 

  3. Shear C, Gipe B, Mattheis J, Levy M. Provider continuity and quality of medical care: a retrospective analysis of prenatal and perinatal outcome. Med Care. 1983;21:1204–10.

    Article  PubMed  CAS  Google Scholar 

  4. Wasson J, Sauvigne A, Mogielnicki R, et al. Continuity of outpatient medical care in elderly men. JAMA. 1984;252:2413–7.

    Article  PubMed  CAS  Google Scholar 

  5. Shea S, Misra D, Ehrlich M, Field L, Francis C. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med. 1992;327(11):776–81.

    Article  PubMed  CAS  Google Scholar 

  6. Grumbach K. Keane D, Bindman AB. Primary care and public emergency department overcrowding. Am J Public Health. 1993;83:372–8.

    Article  PubMed  CAS  Google Scholar 

  7. Katz S, Hofer T. Socioeconomic disparities in preventive care persist despite universal coverage. JAMA. 1994;272:530–4.

    Article  PubMed  CAS  Google Scholar 

  8. Cornelius L, Beauregard K, Cohen J. Usual Sources of Medical Care and Their Characteristics. Rockville, Md: Public Health Service. National Medical Expenditure Survey Research Findings 11, Agency for Health Care Policy and Research publication 91-0042.

  9. Starfield B. Primary Care. New York, NY: Oxford University Press, 1992.

    Google Scholar 

  10. Institute of Medicine. A Manpower Policy for Primary Health Care. Washington, DC: National Academy of Sciences; 1978;78–102.

    Google Scholar 

  11. Bindman AB, Grumbach K, Osmond D, et al. Preventable hospitalizations and access to health care. JAMA. 1995;274:305–11.

    Article  PubMed  CAS  Google Scholar 

  12. Smeloff EA, Burnett WH, Kelzer P. A geographic framework for coordination of needs assessment for primary medical care in California. Public Health Rep. 1981;96:310–4.

    PubMed  CAS  Google Scholar 

  13. Grumbach K, Seifer S, Vranizan K, Keane D, Huang K, Bindman AB. Physician and clinic supply: impact on preventable hospitalization rates in California. Presented at the California Policy Seminar. 1995: Berkeley.

  14. United States Census. Current Population Survey, 1994.

  15. National Center for Health Statistics. The national health interview survey. 1991.

  16. Guide to Clinical Preventive Services. Report of the U.S. Preventive Services Task Force. Baltimore, Md: Williams and Wilkins; 1989.

    Google Scholar 

  17. Eddy DM. Screening for cervical cancer. Ann Intern Med. 1990;113:214–26.

    PubMed  CAS  Google Scholar 

  18. Thornberry OT, Massey JT. Trends in United States telephone coverage across time and subgroups. In: Groves RM, Biemer PP, Lyberg LE, Massey JT, Nicholls WL, Waksberg J, eds. Telephone Survey Methodology. New York, NY: John Wiley and Sons; 1988.

    Google Scholar 

  19. Brown JB, Adams ME. Patients as reliable reporters of medical care process: recall of ambulatory encounter events. Med Care. 1992;30:400–11.

    Article  PubMed  CAS  Google Scholar 

  20. Freeman H, Blendon R, Aiken L, Sudman S, Mullinex C, Corey C. Americans report on their access to health care. Health Aff (Millwood) 1987;6:6–18.

    Article  CAS  Google Scholar 

  21. Whitman S, Lacey L, Ansell D, Chen EH, Dell J, Phillips CW. Do chart reviews and interviews provide the same information about breast and cervical cancer screening? Int J Epidemiol. 1993;22:393–7.

    Article  PubMed  CAS  Google Scholar 

  22. Hiatt RA, Perez-Stable EJ, Quesenbery C, Sabogal F, Otero-Sabogal R, McPhee SJ. Agreement between self-reported early cancer detection practices and medical audits in Hispanic compared with non-Hispanic white health plan members in Northern California. Prev Med. 1995;24:278–85.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Supported by Robert Wood Johnson Foundation grant 22907 and Agency for Health Care Policy Research (AHCPR) grant HSO7373. Dr. Bindman and Dr. Grumbach are Robert Wood Johnson Foundation Generalist Physician Faculty Scholars.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bindman, A.B., Grumbach, K., Osmond, D. et al. Primary care and receipt of preventive services. J Gen Intern Med 11, 269–276 (1996). https://doi.org/10.1007/BF02598266

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02598266

Key words

Navigation