Primary Care Attributes Associated with Receipt of Preventive Care Services: A National Study

Abstract

Background: Primary care attributes (PCAs) encompassed by patient-centered medical homes may increase receipt of preventive care, though national studies are lacking.

Methods: We performed cross-sectional adjusted analyses of self-report data from adults in the 2007 to 2010 US Medical Expenditure Panel Surveys (N = 50,457). PCAs were considered individually and as a total score for each respondent and included comprehensiveness (a usual source of care for new and ongoing problems, preventive care, and referrals); patient-centeredness (shared decision making); and enhanced access (night and weekend hours). Preventive care measures included mammography, influenza vaccination, annual exams, colorectal cancer screening, and Papanicolaou, prostate-specific antigen, and cholesterol testing.

Results: The total PCA score was positively associated with increased receipt of each preventive care measure. Colorectal cancer screening (18.5%) and prostate-specific antigen testing (20.7%) showed the largest increases across PCA score quartiles. Individual primary care attributes except enhanced access were positively associated with each preventive care measure. Enhanced access was negatively associated with annual examination (adjusted odds ratio, 0.83; 95% confidence interval, 0.77-0.91).

Conclusion: In a nationally representative sample, greater reported exposure to key primary care attributes, with the exception of enhanced access, was associated with increased preventive care. These findings may inform best practices for maximizing preventive care delivery.

Keywords: Medical Home; Preventive Medicine.