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Article
Effects of sustained audit/feedback on self-reported health status of primary care patients
Quantitative Health Sciences Publications and Presentations
  • Stephan D. Fihn, University of Washington
  • Mary B. McDonell
  • Paula Diehr
  • Stephen M. Anderson
  • Katharine A. Bradley, University of Washington
  • David H. Au, University of Washington
  • John A. Spertus, University of Missouri
  • Marcia Burman, University of Washington
  • Gayle E. Reiber, University of Washington
  • Catarina I. Kiefe, University of Massachusetts Medical School
  • Marisue Cody
  • Karen M. Sanders
  • Mary A. Whooley, University of California
  • Kenneth Rosenfeld
  • Linda A. Baczek
  • Arthur Sauvigne
UMMS Affiliation
Department of Quantitative Health Sciences
Date
2-19-2004
Document Type
Article
Medical Subject Headings
Aged; Chronic Disease; Female; *Health Status; Health Surveys; Humans; Male; Medical Audit; *Patient Satisfaction; Physical Fitness; *Primary Health Care; Questionnaires; United States; United States Department of Veterans Affairs
Abstract

PURPOSE: Because limited audit/feedback of health status information has yielded mixed results, we evaluated the effects of a sustained program of audit/feedback on patient health and satisfaction.

METHODS: We conducted a group-randomized effectiveness trial in which firms within Veterans Administration general internal medicine clinics served as units of randomization, intervention, and analysis. Respondents to a baseline health inventory were regularly mailed the 36-Item Short Form (SF-36) and, as relevant, questionnaires about six chronic conditions (ischemic heart disease, diabetes, chronic obstructive pulmonary disease, depression, alcohol use, and hypertension) and satisfaction with care. Data were reported to primary providers at individual patient visits and in aggregate during a 2-year period.

RESULTS: Baseline forms were mailed to 34,050 patients; of the 22,413 respondents, 15,346 completed and returned follow-up surveys. Over the 2-year study, the difference between intervention and control groups (as measured by difference in average slope) was -0.26 (95% confidence interval [CI]: -0.79 to 0.27; P=0.28) for the SF-36 Physical Component Summary score and -0.53 (95% CI: -1.09 to 0.03; P=0.06) for the SF-36 Mental Component Summary score. No significant differences emerged after adjusting for deaths. There were no significant differences in condition-specific measures or satisfaction between groups after adjustment for provider type, panel size, and number of intervention visits, or after analysis of patients who completed all forms.

CONCLUSION: An elaborate, sustained audit/feedback program of general and condition-specific measures of health/satisfaction did not improve outcomes. To be effective, such data probably should be incorporated into a comprehensive chronic disease management program.

Rights and Permissions
Citation: Am J Med. 2004 Feb 15;116(4):241-8. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Citation Information
Stephan D. Fihn, Mary B. McDonell, Paula Diehr, Stephen M. Anderson, et al.. "Effects of sustained audit/feedback on self-reported health status of primary care patients" Vol. 116 Iss. 4 (2004) ISSN: 0002-9343 (Linking)
Available at: http://works.bepress.com/catarina_kiefe/80/