Crawford Albert G, Sikirica Vanja, Goldfarb Neil, Popiel Richard G, Patel Minalkumar, Wang Cheng, Chu Jeffrey B, Nash David B
Department of Health Policy, Jefferson Medical College, 1015 Walnut Street, Suite 115, Philadelphia, PA 19107, USA.
Am J Med Qual. 2005 Nov-Dec;20(6):329-36. doi: 10.1177/1062860605281176.
This study evaluated the effects of interactive voice response (IVR) system reminders to managed care organization (MCO) members to obtain mammograms, Papanicolaou (Pap) tests, and influenza immunizations. The MCO identified 3 member cohorts and sent IVR reminders to get preventive services. Analyses employed claims data to examine relationships between IVR reminders and preventive service use 5 to 9 months post-intervention among members without prior utilization. Multivariate logistic regressions controlling for age, gender (for influenza immunizations), and risk stratum confirmed hypothesized relationships between intervention and preventive services: mammograms, odds ratio (OR) = 1.263 (95% confidence interval [CI] = 1.104, 1.444); Pap tests, OR = 1.241 (1.107, 1.391); influenza immunizations, OR = 2.072 (1.665, 2.580). IVR reminders are associated with higher rates of mammograms, Pap tests, and influenza immunizations. Study limitations include unknown generalizability of results and possible self-selection. There is justification for more IVR interventions and research to enhance MCO members' preventive service utilization.
本研究评估了交互式语音应答（IVR）系统提醒对管理式医疗组织（MCO）成员进行乳房X光检查、巴氏试验（Pap）和流感疫苗接种的效果。MCO确定了3个成员队列，并发送IVR提醒以获取预防性服务。分析采用索赔数据来检查IVR提醒与干预后5至9个月内未事先使用过预防性服务的成员的预防性服务使用之间的关系。控制年龄、性别（针对流感疫苗接种）和风险分层的多变量逻辑回归证实了干预与预防性服务之间的假设关系：乳房X光检查，优势比（OR）=1.263（95%置信区间[CI]=1.104，1.444）；巴氏试验，OR=1.241（1.107，1.391）；流感疫苗接种，OR=2.072（1.665，2.580）。IVR提醒与更高的乳房X光检查、巴氏试验和流感疫苗接种率相关。研究局限性包括结果的普遍适用性未知以及可能存在自我选择。有理由进行更多的IVR干预和研究，以提高MCO成员对预防性服务的利用率。
