Abstract
BackgroundIt is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients.MethodsIn a cross-sectional study adults aged 18 years and over attending primary care physician (PCP) offices located in Southern Italy were interviewed from June through December 2007. Quality indicators of preventive health care developed from RAND's Quality Assessment Tools and Behavioral Risk Factor Surveillance System (BRFSS) were used. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on delivery of clinical preventive services.ResultsA total of 1467 subjects participated in the study. Excepting blood pressure preventive check (delivered to 64.4% of eligible subjects) and influenza vaccination (recommended to 90.2% of elderly), the rates of delivery of clinical preventive services were low across all measures, particularly for screening and counseling on health habits. Rates for providing cancer screening tests at recommended times were 21.3% for colonoscopy, 51.5% for mammography and 52.4% for Pap smear. Statistical analysis showed clear disparities in the provision of clinical preventive services associated with age, gender, education level, perceived health status, current health conditions and primary care access measures.ConclusionsThere is overwhelming need to develop and implement effective interventions to improve delivery of routine clinical preventive services.
Highlights
It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality
In Italy, where universal and free access to interventions included in the Basic Healthcare Parameters is provided through the National Health Service (NHS), financial resources for prevention are very limited; preventive healthcare that is provided by Prevention Departments and primary care physicians (PCPs), is often not properly organized
Study population A cross-sectional study was conducted at waiting rooms of 20 PCPs in two cities of Southern Italy (Catanzaro and Crotone), randomly selected from lists provided by the Local Health Units
Summary
It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients. Scientific consensus holds that the provision of clinical preventive services to adults can identify and detect many causes of adult mortality. To assess the extent to which the healthcare system succeeds in providing essential clinical preventive services, composite measures have been developed. Among these measures, the RAND’s Quality Assessment Tools system has been extensively used to assess the quality of. Studies have demonstrated a striking imbalance in the provision of preventive health services, especially in breast, cervical and colorectal cancer screening, with higher coverage always in Northern and Central Italy compared to Southern Italy, where organised systematic screening activity has not yet been completely implemented [7,8,9]
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