Preventive Services Delivery in Patients With Chronic Illnesses: Parallel Opportunities Rather Than Competing Obligations
| Autor: | Ruth G. Jenkins, Paul J. Nietert, Cara B. Litvin, Andrea M. Wessell, Steven M. Ornstein |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Community-Based Participatory Research medicine.medical_specialty Office Visits Health Services Accessibility Odds Young Adult Patient-Centered Care Preventive Health Services Health care medicine Humans In patient Original Research Quality of Health Care Service (business) Receipt Primary Health Care business.industry Public health Odds ratio Middle Aged medicine.disease Comorbidity United States Cross-Sectional Studies Family medicine Chronic Disease Female Family Practice business |
| Zdroj: | The Annals of Family Medicine. 11:344-349 |
| ISSN: | 1544-1717 1544-1709 |
| DOI: | 10.1370/afm.1502 |
| Popis: | PURPOSE Whether patients with 1 or more chronic illnesses are more or less likely to receive recommended preventive services is unclear and an important public health and health care system issue. We addressed this issue in a large national practice-based research network (PBRN) that maintains a longitudinal database derived from electronic health records. METHODS We conducted a cross-sectional study as of October 1, 2011, of the association between being up to date with 10 preventive services and the preva- lence of 24 chronic illnesses among 667,379 active patients aged 18 years or older in 148 member practices in a national PBRN. We used generalized linear mixed models to assess for the association of being up to date with each preven- tive service as a function of the patient's number of chronic conditions, adjusted for patient age and encounter frequency. RESULTS Of the patients 65.4% had at least 1 of the 24 chronic illnesses. For 9 of the 10 preventive services there were strong associations between the odds of being up to date and the presence of chronic illness, even after adjustment for visit frequency and patient age. Odds ratios increased with the number of chronic conditions for 5 of the preventive services. CONCLUSIONS Rather than a barrier, the presence of chronic illness was posi- tively associated with receipt of recommended preventive services in this large national PBRN. This finding supports the notion that modern primary care prac - tice can effectively deliver preventive services to the growing number of patients with multiple chronic illnesses. |
| Databáze: | OpenAIRE |
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