CDC Highlights Underuse of Clinical Preventive Services in U.S.

Just half of U.S. adults received clinical preventive services, such as screenings and prescriptions, from 2007 to 2010, according to a CDC study. Published as a supplement to MMWR, the report is intended to provide baseline data on the preventive services available before the Affordable Care Act was passed.

Among the notable findings:

• Less than half of people with ischemic cardiovascular disease were prescribed aspirin or other antiplatelet drugs.
• Less than half of those with hypertension had it under control.
• In the preceding 5 years, only 68% had their cholesterol assessed.
• Over a third of outpatient visits had no record of the patient's tobacco use. Of the patients who screened positive for tobacco use, only 21% received counseling and 8% received prescriptions for cessation medications.
• People without insurance were 10% to 30% less likely to use such preventive services, compared with population averages. The CDC suggests that improving insurance coverage could increase use of these services.

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COMMENT: Drs. are tought to treat symptoms and focus their limited time on whatever the patient is complaing about.  It is to be expected that screening and preventative services will fall out of such a model.  The only way we are going to fix this is by the application of the principles of the chronic disease model http://www.improvingchroniccare.org/index.php?p=the_chronic_care_model&s=2  An isolated physician in a clinic cannot do this.  51 % of American physicians are in solo practice.  Combine that with the financial incentives of the fee for service model and you get little preventative care.  What is interesting is that other financial models do not seem to be much better, i. e. the British system.  i wonder if the per cent of solo practitioners versus the larger group practices in the various BHS administrative units correlates with the performance of prevenative services.  It should if the larger practives use team care.  Any data on this?