Rosser W W, McDowell I, Newell C
Department of Family and Community Medicine, University of Toronto, Ont.
CMAJ. 1991 Oct 1;145(7):807-14.
To compare the effectiveness of three computerized reminder systems in the delivery of five preventive procedures in family practice.
Prospective, randomized, controlled study.
Ottawa Civic Hospital Family Medicine Centre.
Of 8502 patients 15 years of age or more who were not in a hospital or institution 5883 were randomly assigned, by family, to a control group, a physician reminder group (passive) or a telephone or letter reminder group (active). The remaining 2619 patients were not included in the randomized portion of the study but were monitored.
During 1 year the patients in the active reminder groups received a telephone call or letter reminding them of any overdue preventive procedures; for those in the passive reminder group the physician was reminded at an office visit to provide any overdue service.
Rates of completion of the preventive procedures required.
All three reminder systems significantly improved the delivery of preventive services (p less than 0.001). The procedure completion rates were 42.0% in the letter reminder group, 42.0% in the telephone reminder group, 33.7% in the physician reminder group and 14.1% in the randomized control group. The use of a letter was more cost-effective than the telephone system, but the physician reminder system was the most cost-effective.
Computerized reminder systems do improve the delivery of preventive services in family practice.
比较三种计算机提醒系统在家庭医疗中提供五项预防性医疗程序的有效性。
前瞻性、随机对照研究。
渥太华市民医院家庭医学中心。
在8502名15岁及以上未住院或未在医疗机构的患者中,5883名患者按家庭随机分为对照组、医生提醒组(被动)或电话或信件提醒组(主动)。其余2619名患者未纳入研究的随机部分,但进行了监测。
在1年期间,主动提醒组的患者接到电话或信件,提醒他们任何逾期的预防性医疗程序;对于被动提醒组的患者,在门诊时提醒医生提供任何逾期服务。
所需预防性医疗程序的完成率。
所有三种提醒系统均显著提高了预防性服务的提供(p<0.001)。信件提醒组的程序完成率为42.0%,电话提醒组为42.0%,医生提醒组为33.7%,随机对照组为14.1%。使用信件比电话系统更具成本效益,但医生提醒系统是最具成本效益的。
计算机提醒系统确实能改善家庭医疗中预防性服务的提供。