Effects of sustained audit/feedback on self-reported health status of primary care patients
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Authors
Fihn, Stephan D.McDonell, Mary B.
Diehr, Paula
Anderson, Stephen M.
Bradley, Katharine A.
Au, David H.
Spertus, John A.
Burman, Marcia
Reiber, Gayle E.
Kiefe, Catarina I.
Cody, Marisue
Sanders, Karen M.
Whooley, Mary A.
Rosenfeld, Kenneth
Baczek, Linda A.
Sauvigne, Arthur
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2004-02-19Keywords
AgedChronic Disease
Female
*Health Status
Health Surveys
Humans
Male
Medical Audit
*Patient Satisfaction
Physical Fitness
*Primary Health Care
Questionnaires
United States
United States Department of Veterans Affairs
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
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PURPOSE: Because limited audit/feedback of health status information has yielded mixed results, we evaluated the effects of a sustained program of audit/feedback on patient health and satisfaction. METHODS: We conducted a group-randomized effectiveness trial in which firms within Veterans Administration general internal medicine clinics served as units of randomization, intervention, and analysis. Respondents to a baseline health inventory were regularly mailed the 36-Item Short Form (SF-36) and, as relevant, questionnaires about six chronic conditions (ischemic heart disease, diabetes, chronic obstructive pulmonary disease, depression, alcohol use, and hypertension) and satisfaction with care. Data were reported to primary providers at individual patient visits and in aggregate during a 2-year period. RESULTS: Baseline forms were mailed to 34,050 patients; of the 22,413 respondents, 15,346 completed and returned follow-up surveys. Over the 2-year study, the difference between intervention and control groups (as measured by difference in average slope) was -0.26 (95% confidence interval [CI]: -0.79 to 0.27; P=0.28) for the SF-36 Physical Component Summary score and -0.53 (95% CI: -1.09 to 0.03; P=0.06) for the SF-36 Mental Component Summary score. No significant differences emerged after adjusting for deaths. There were no significant differences in condition-specific measures or satisfaction between groups after adjustment for provider type, panel size, and number of intervention visits, or after analysis of patients who completed all forms. CONCLUSION: An elaborate, sustained audit/feedback program of general and condition-specific measures of health/satisfaction did not improve outcomes. To be effective, such data probably should be incorporated into a comprehensive chronic disease management program.Source
Am J Med. 2004 Feb 15;116(4):241-8. Link to article on publisher's siteDOI
10.1016/j.amjmed.2003.10.026Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47651PubMed ID
14969652Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.amjmed.2003.10.026
Scopus Count
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