--- title: "Priority of preventive health services in visits. | Sutter Health" description: "To evaluate the multilevel factors associated with evidence-based preventive service delivery during periodic health examinations." url: "https://www.sutterhealth.org/research/publications/priority-of-preventive-health-services-in-visits-1055312580" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Priority of preventive health services in visits. # Prioritization of evidence-based preventive health services during periodic health examinations. Shires DA, Stange KC, Divine G, Ratliff S, Vashi R, Tai-Seale M, & Lafata JE. _Am J Prev Med. 42(2):164-73. doi: 10.1016/j.amepre.2011.10.008._ 2012-02-01 ## Abstract BACKGROUND: Delivery of preventive services sometimes falls short of guideline recommendations. PURPOSE: To evaluate the multilevel factors associated with evidence-based preventive service delivery during periodic health examinations (PHEs). METHODS: Primary care physicians were recruited from an integrated delivery system in southeast Michigan. Audio recordings of PHE office visits conducted from 2007 to 2009 were used to ascertain physician recommendation for or delivery of 19 guideline-recommended preventive services. Alternating logistic regression was used to evaluate factors associated with service delivery. Data analyses were completed in 2011. RESULTS: Among 484 PHE visits to 64 general internal medicine and family physicians by insured patients aged 50-80 years, there were 2662 services for which patients were due; 54% were recommended or delivered. Regression analyses indicated that the likelihood of service delivery decreased with patient age and with each concern the patient raised, and it increased with increasing BMI and with each additional minute after the scheduled appointment time the physician first presented. The likelihood was greater with patient-physician gender concordance and less if the physician used the electronic medical record in the exam room or had seen the patient in the past 12 months. CONCLUSIONS: A combination of patient, patient-physician relationship, and visit contextual factors are associated with preventive service delivery. Additional studies are warranted to understand the complex interplay of factors that support and compromise preventive service delivery. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/?term=Prioritization+of+Evidence-based+Preventive+Health+Services) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes.](https://www.sutterhealth.org/research/publications/preval-correlates-md-geriat-pt-lifestyle-discuss-1055312586) Ory MG, Yuma PJ, Hurwicz ML, Jarvis C, Barron KL, Tai-Seale T, Tai-Seale M, Patel D, Hackethorn D, Bramson R, Street R, Cook MA. Prev Med. 43(6):494-7. Epub 2006 Aug 9. 2006 Dec 06 - Publication ### [Medicare annual preventive care visits: use increased among fee-for-service patients, but many do not participate.](https://www.sutterhealth.org/research/publications/medicare-preventive-care-in-fee-for-svce-pts-1055312874) Chung S, Lesser LI, Lauderdale DS, Johns NE, Palaniappan LP, Luft HS. Health Aff (Millwood). 34(1):11-20. doi: 10.1377/hlthaff.2014.0483. 2015 Jan 01 - Publication ### [Using citizen scientists to gather, analyze, and disseminate information about neighborhood features that affect active living.](https://www.sutterhealth.org/research/publications/use-citizen-scientists-gather-info-active-living-1055312885) Winter SJ, Goldman Rosas L, Padilla Romero P, Sheats JL, Buman MP, Baker C, King AC. 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Death Stud. 1-10. \[Epub ahead of print\] 2016 Nov 04 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/priority-of-preventive-health-services-in-visits-1055312580#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Priority of preventive health services in visits."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/priority-of-preventive-health-services-in-visits-1055312580#medicalscholarlyarticle","name":"Prioritization of evidence-based preventive health services during periodic health examinations.","headline":"Priority of preventive health services in visits.","abstract":"BACKGROUND: Delivery of preventive services sometimes falls short of guideline recommendations. PURPOSE: To evaluate the multilevel factors associated with evidence-based preventive service delivery during periodic health examinations (PHEs). METHODS: Primary care physicians were recruited from an integrated delivery system in southeast Michigan. Audio recordings of PHE office visits conducted from 2007 to 2009 were used to ascertain physician recommendation for or delivery of 19 guideline-recommended preventive services. Alternating logistic regression was used to evaluate factors associated with service delivery. Data analyses were completed in 2011. RESULTS: Among 484 PHE visits to 64 general internal medicine and family physicians by insured patients aged 50-80 years, there were 2662 services for which patients were due; 54% were recommended or delivered. Regression analyses indicated that the likelihood of service delivery decreased with patient age and with each concern the patient raised, and it increased with increasing BMI and with each additional minute after the scheduled appointment time the physician first presented. The likelihood was greater with patient-physician gender concordance and less if the physician used the electronic medical record in the exam room or had seen the patient in the past 12 months. CONCLUSIONS: A combination of patient, patient-physician relationship, and visit contextual factors are associated with preventive service delivery. 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