Schmittdiel Julie, McMenamin Sara B, Halpin Helen Ann, Gillies Robin R, Bodenheimer Thomas, Shortell Stephen M, Rundall Thomas, Casalino Lawrence P
Division of Health Policy and Management, School of Public Health, University of California, Berkeley, CA 94720, USA.
Prev Med. 2004 Nov;39(5):1000-6. doi: 10.1016/j.ypmed.2004.04.005.
Clinical preventive services improve patient health, and reminder systems can increase the use of such services. However, physician organizations often underutilize clinical preventive service reminders. Little is known about the incentives, capabilities, and organizational characteristics associated with the use of reminders by physician organizations.
The predictors of patient and physician reminder system use were examined in a sample of 1,104 US physician organizations. The cross-sectional sample was obtained through a telephone survey with a 70% response rate.
Fifty-one percent of physician organizations used mammogram reminders, 41% used influenza immunization reminders, and 26% used eye exam reminders for patients. Eighteen percent of physician organizations used computer-generated reminders to physicians. Required reporting of data (P = 0.0006), public recognition for quality (P = 0.0002), and IT capabilities (P < 0.0001) were strongly associated with patient reminder use. Medical groups were more likely to use patient-level reminders than independent practice associations (IPAs) (P < 0.0001). Physician reminder use was related to required reporting of data (P < 0.0001) and IT capabilities (P < 0.0001).
Physician organizations have relatively low use of preventive service reminders to patients and physicians. Offering quality incentives to physician organizations and improving their IT capabilities may increase the use of preventive service reminders and improve the delivery of preventive care.
临床预防服务可改善患者健康状况，提醒系统能增加此类服务的使用。然而，医师组织往往未充分利用临床预防服务提醒。对于医师组织使用提醒相关的激励措施、能力及组织特征，我们知之甚少。
在1104个美国医师组织的样本中，研究患者及医师提醒系统使用的预测因素。该横断面样本通过电话调查获得，应答率为70%。
51%的医师组织使用乳房X光检查提醒，41%使用流感疫苗接种提醒，26%为患者使用眼部检查提醒。18%的医师组织使用计算机生成的医师提醒。数据的强制报告（P = 0.0006）、质量方面的公众认可（P = 0.0002）以及信息技术能力（P < 0.0001）与患者提醒的使用密切相关。医疗集团比独立执业协会（IPA）更有可能使用患者层面的提醒（P < 0.0001）。医师提醒的使用与数据的强制报告（P < 0.0001）和信息技术能力（P < 0.0001）有关。
医师组织对患者和医师的预防服务提醒使用相对较少。向医师组织提供质量激励并提高其信息技术能力，可能会增加预防服务提醒的使用，并改善预防保健的提供。
