Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan;15(1):14-22.
doi: 10.1370/afm.2017. Epub 2017 Jan 6.

Updated Priorities Among Effective Clinical Preventive Services

Michael V Maciosek  1 , Amy B LaFrance  2 , Steven P Dehmer  2 , Dana A McGree  2 , Thomas J Flottemesch  2 , Zack Xu  2 , Leif I Solberg  2
Affiliations

Updated Priorities Among Effective Clinical Preventive Services

Michael V Maciosek et al. Ann Fam Med. 2017 Jan.

Erratum in

  • CORRECTION.
    [No authors listed] [No authors listed] Ann Fam Med. 2017 Mar;15(2):104. doi: 10.1370/afm.2047. Ann Fam Med. 2017. PMID: 31305755 Free PMC article.

Abstract

Purpose: The Patient Protection and Affordable Care Act's provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services.

Methods: We assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures-cost-effectiveness and clinically preventable burden-for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally.

Results: The 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesity-related behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations.

Conclusions: This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives.

Keywords: behavioral counseling; cost-effectiveness; cost-savings; disease, prevention & control; economics; health impact; health services; immunization; mass screening; prioritization.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: authors report none.

Comment in

References

    1. Coffield AB, Maciosek MV, McGinnis JM, et al. Priorities among recommended clinical preventive services. Am J Prev Med. 2001; 21(1):1–9. - PubMed
    1. Maciosek MV, Coffield AB, Edwards NM, Flottemesch TJ, Goodman MJ, Solberg LI. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006;31(1):52–61. - PubMed
    1. Berwick DM, Nolan TW, Whittington J. The Triple Aim: care, health, and cost. Health Aff (Millwood). 2008;27(3):759–769. - PubMed
    1. Jackson GL, Powers BJ, Chatterjee R, et al. Improving patient care. The patient centered medical home. A Systematic Review. Ann Intern Med. 2013;158(3):169–178. - PubMed
    1. Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF. Principles of the patient-centered medical home and preventive services delivery. Ann Fam Med. 2010;8(2):108–116. - PMC - PubMed

Publication types