ARE PHYSICIANS LESS LIKELY TO RECOMMEND PREVENTIVE SERVICES TO LOW-SES PATIENTS

Background. Do low-SES adult patients visiting private primary care cl inics differ from higher SES adult patients in their need for eight pr eventive services Or in receiving either a recommendation for or the n eeded services? Methods. Randomly identified adult patients were surve yed within 2 weeks of a visit to 22 clinics in the Minneapolis-St. Pau l area. Questions assessed patient recollection of the latest receipt of eight services and whether needed services had been recommended dar ing the visit or received then soon after. Results. Of those surveyed, 4,245 patients (1,650 low SES) responded (84.3%), showing that low SE S patients were less likely to be up to date for cholesterol measureme nt, Pap smear, mammography, breast exam, and flu or pneumonia shots (P < 0.004), but not for blood pressure. measurement. Low-SES patients n eeding services received recommendations to have them and actually rec eived them at the same rate as higher SES patients. Conclusions. The 2 2 primary care clinics studied appear to be recommending and providing needed preventive services to visiting patients at the same rate rega rdless of income or insurance status. The reasons for differences in p revention status by SES are complex but the low proportion of all pati ents receiving recommendations for needed services suggests the need t o take advantage of all visits for updating prevention needs. (C) 1997 Academic Press.