Delivery rates for preventive services in 44 midwestern clinics

Mayo Clin Proc. 1997 Jun;72(6):515-23. doi: 10.4065/72.6.515.


Objective: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations.

Material and methods: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4%) completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit.

Results: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33%). Except for blood pressure and smoking cessation advice, less than 30% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important.

Conclusion: Preventive services consensus goals are not being met, even for patients who report that their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Diagnostic Tests, Routine / standards
  • Diagnostic Tests, Routine / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minnesota
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Preventive Health Services / statistics & numerical data*
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data*
  • Quality of Health Care