Primary care physicians' use of office resources in the provision of preventive care
L. L. Dickey and D. B. Kamerow
Department of Family and Community Medicine, University of California, San Francisco, USA.
OBJECTIVES: To assess (1) the extent to which office resources (eg, chart
aids, educational materials, office staff) are used by primary care
physicians in the provision of preventive care; (2) the characteristics of
physicians associated with this use; and (3) the relationship of office
resource use to reported preventive service provision. DESIGN: Survey.
SUBJECTS: Randomly selected active members of the American Academy of
Family Physicians, Kansas City, Mo, American Academy of Pediatrics, Elk
Grove Village, III, American College of Obstetricians and Gynecologists,
Washington, DC, and American College of Physicians, Philadelphia, Pa. MALE
OUTCOME MEASURES: Use rates for each of 14 types of office resources, and
scores for total office resource use, total preventive service provision,
and counseling, screening, and immunization provision. RESULTS: Most types
of office resources were used by less than 50% of the physicians.
Physicians in small private practices reported less use of resources than
those in other settings. The chart flow sheet was the resource that was
most strongly and consistently related to preventive service provision. For
all organizations, the total resource use score was significantly
correlated with scores for total preventive service provision, and
counseling and immunization provision. For most organizations, the total
resource use score was more highly related to total preventive service
provision than was the age or sex of the physician, the percentage of
patients uninsured or with Medicaid coverage, or community size.
CONCLUSIONS: The use of office resources is an important factor in the
provision of preventive care. Intervention efforts to improve office
resource use may benefit from targeting by resource type, practice setting,
physician specialty, and other physician and practice characteristics.
