THE ASSOCIATION OF ATTRIBUTES OF PRIMARY-CARE WITH THE DELIVERY OF CLINICAL PREVENTIVE SERVICES

OBJECTIVES. Evidence is building that primary care is associated with quality of care and cost effectiveness. Still, little is known of the contribution of specific attributes of primary care to important healt h outcomes, such as the delivery of preventive services. This study te sts the association of specific attributes of primary care with a comp rehensive measure of the delivery of preventive services. METHODS. A c ross-sectional multimethod study design was used to examine 2,889 pati ent visits to 138 community-based primary care physicians. Four primar y care attributes were measured: patient preference for their regular physician, interpersonal communication, physician's accumulated knowle dge of the patient, and coordination of care. Delivery of US Preventiv e Service Task Force-recommended services were based on data collected from direct observation and medical record review. Hierarchical linea r regression models (HLM) were used to test the association of each of the primary care attributes with being up to date on screening, immun ization, and health habit counseling preventive services. Each regress ion model was adjusted for patient age, race, health status, and insur ance type. RESULTS. Interpersonal communication and coordination of ca re scale scores were associated with being more up to date on screenin g services and health habit counseling. Accumulated knowledge and pref erence for regular physician were associated with being more up to dat e on immunizations. CONCLUSIONS. The attributes of primary care measur ed in this study are associated with the receipt of preventive service s. Fostering the tenets of primary care may have an impact on the deli very of preventive services and possibly other important health outcom es.