Fewer Than 1 in 10 Adults Get All High-Priority Preventive Care

Marcia Frellick

June 08, 2018

Only 8% of US adults aged 35 years or older received all of the high-priority preventive care recommended for them, according to results of a survey published in the June issue of Health Affairs.

Conversely, 5% of adults received none of those services.

Amanda Borsky, DrPH, MPP, a dissemination and implementation adviser in the Center for Evidence and Practice Improvement at the Agency for Healthcare Research and Quality in Rockville, Maryland, and colleagues found that the most commonly received preventive service in 2015 was blood pressure screening (87.3%), and the least commonly received was zoster vaccination for shingles (37.9%).

"People expect and deserve to receive all of the evidence-based clinical preventive services that are appropriate for them," the authors write.

Common reasons for not getting preventive services include lack of insurance, lack of a usual source of care, and delayed access to care.

15 Prevention Services Studied

The researchers used data from the Preventive Services Self-Administered Questionnaire of the Agency for Healthcare Research and Quality Medical Expenditure Panel Survey from January to May 2015 to examine receipt of 15 preventive measures: screenings for blood pressure, cholesterol, breast cancer, colon cancer, cervical cancer, osteoporosis, and prostate-specific antigen; screening and counseling for tobacco, obesity, alcohol use, and depression; influenza, zoster, and pneumococcal vaccines; and counseling for aspirin use.

Among the 2759 adults aged 35 years and older eligible to complete the Preventive Services Self-Administered Questionnaire, 2186 (79.2%) did.

With respect to the proportion of respondents who received all appropriate preventive care, there was no significant difference between men and women or by age. However, men were almost twice as likely as women to receive 25% or fewer of the services (21.9% vs 11.3 %; P < .001). Men were also 3 times as likely as women to have received no recommended services (7.3% vs 2.4%; P < .001).

"The only service received more often by men than women was counseling on aspirin use," the authors write.

The 15 measures were identified with guidance from an expert national steering committee. Each measure had to be evidence-based (based on recommendations from the US Preventive Services Task Force or the Advisory Committee on Immunization Practices), relevant, and actionable.

One of the limitations of the survey was that it relied on self-report, and people may not have accurately remembered whether they had received a service or how long it had been since they had it.

The Preventive Services Self-Administered Questionnaire is now a standard component of the Medical Expenditure Panel Survey, and information will be collected again in 2018. This will allow health systems and individual practices to monitor over time who is receiving the high-priority preventive services.

The authors have disclosed no relevant financial relationships.

Health Aff. 2018;37:925-928

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