At the time the study was conducted, both authors were with the Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY. Natalie Privett was also with the Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai.
Am J Public Health. 2021 Jan;111(1):145-149. doi: 10.2105/AJPH.2020.305967. Epub 2020 Nov 19.
To reexamine the time required to provide the US Preventive Services Task Force (USPSTF)-recommended preventive services to a nationally representative adult patient panel of 2500. We determined the required time for a single physician to deliver the USPSTF preventive services by multiplying the eligible population, annual frequency, and patient-contact time required for each recommendation, all calculated by using data from the recommendations themselves and literature. We modeled a representative panel of 2500 adults based on the 2010 US Census Bureau data. To deliver the USPSTF recommended preventive services across a 2500 adult patient panel would require 8.6 hours per working day, accounting for 131% of available physician time. Compared with 2003, there are fewer recommendations in 2020, but they require 1.2 more physician patient-contact hours per working day. The time required to deliver recommended preventive care places unrealistic expectations on already overwhelmed providers and leaves patients at risk. This is a systems problem, not a time-management problem. The USPSTF provides a set of recommendations with strong evidence of positive impact. It is imperative that our health care system is designed to deliver.
重新审视为 2500 名具有代表性的成年患者群体提供美国预防服务工作组 (USPSTF) 推荐的预防服务所需的时间。我们通过将符合条件的人群、每年的频率以及每个建议所需的患者接触时间相乘，来确定单个医生提供 USPSTF 预防服务所需的时间，所有这些都是根据建议本身和文献中的数据计算得出的。我们根据 2010 年美国人口普查局的数据，对 2500 名成年患者进行了代表性的模拟。要在 2500 名成年患者中提供 USPSTF 推荐的预防服务，每个工作日需要 8.6 小时，占医生可用时间的 131%。与 2003 年相比，2020 年的建议更少，但每个工作日需要增加 1.2 个医生与患者的接触时间。提供推荐的预防保健所需的时间给已经不堪重负的提供者带来了不切实际的期望，并使患者面临风险。这是一个系统问题，而不是时间管理问题。USPSTF 提供了一套具有积极影响的强有力证据的建议。至关重要的是，我们的医疗保健系统必须能够提供这些建议。
