Hahn D L, Berger M G
Arcand Park Clinic, Division of Dean Medical Center, Madison, WI 53704.
J Fam Pract. 1990 Nov;31(5):492-502; discussion 502-4.
The impact of a policy to introduce a simple health maintenance protocol systematically to all patients belonging to a private practice is reported. Results after 18 months' experience in over 1400 patients indicate that (1) physician compliance was excellent (97% of eligible patients were included, and physician time taken to introduce the protocol at the index visit took less than 4 minutes), and (2) patient acceptance (which varied from procedure to procedure) was good to excellent (minimum acceptance: 77% for sigmoidoscopy; maximum acceptance: 97% for cholesterol screening). For patients seen once, acceptance rates for procedures were generally comparable to prior published performance rates for highly selected patient populations. Integration of a simple health maintenance protocol into routine office care of unselected primary care patients was feasible, effective, and acceptable to patients. Patient refusal was a minor barrier to performance of health maintenance.
报告了一项向一家私人诊所的所有患者系统引入简单健康维护方案的政策的影响。对1400多名患者进行18个月的实践后的结果表明：（1）医生的依从性极佳（97%的符合条件患者被纳入，在初次就诊时引入该方案的医生用时不到4分钟）；（2）患者的接受度（因检查项目而异）良好至极佳（最低接受率：乙状结肠镜检查为77%；最高接受率：胆固醇筛查为97%）。对于只就诊一次的患者，各项检查的接受率总体上与先前针对高度精选患者群体公布的执行率相当。将简单的健康维护方案纳入未选定的初级保健患者的常规门诊护理是可行、有效的，且患者可接受。患者拒绝是健康维护实施的一个小障碍。
