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Primary Care Physicians' Use of Office Resources in the Provision of Preventive Care
Larry L. Dickey, MD, MSW, MPH;
Douglas B. Kamerow, MD, MPH
Arch Fam Med. 1996;5(7):399-404.
Abstract
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Objectives
To assess (1) the extent to which office resources (eg, chart aids, educational materials, office staff) are used by primary care physicians in the provision of preventive care; (2) the characteristics of physicians associated with this use; and (3) the relationship of office resource use to reported preventive service provision.
Design
Survey.
Subjects
Randomly selected active members of the American Academy of Family Physicians, Kansas City, Mo, American Academy of Pediatrics, Elk Grove Village, Ill, American College of Obstetricians and Gynecologists, Washington, DC, and American College of Physicians, Philadelphia, Pa.
Main Outcome Measures
Use rates for each of 14 types of office resources, and scores for total office resource use, total preventive service provision, and counseling, screening, and immunization provision.
Results
Most types of office resources were used by less than 50% of the physicians. Physicians in small private practices reported less use of resources than those in other settings. The chart flow sheet was the resource that was most strongly and consistently related to preventive service provision. For all organizations, the total resource use score was significantly correlated with scores for total preventive service provision, and counseling and immunization provision. For most organizations, the total resource use score was more highly related to total preventive service provision than was the age or sex of the physician, the percentage of patients uninsured or with Medicaid coverage, or community size.
Conclusions
The use of office resources is an important factor in the provision of preventive care. Intervention efforts to improve office resource use may benefit from targeting by resource type, practice setting, physician specialty, and other physician and practice characteristics.
Author Affiliations
From the Department of Family and Community Medicine, University of California, San Francisco (Dr Dickey), and the Office of the Forum for Quality and Effectiveness in Health Care, Agency for Health Care Policy and Research, Public Health Service, Washington, DC (Dr Kamerow).
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