RT Journal
A1 Mehrotra A, Zaslavsky AM, Ayanian JZ
T1 PReventive health examinations and preventive gynecological examinations in the united states
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2007
FD September 24
VO 167
IS 17
SP 1876
OP 1883
DO 10.1001/archinte.167.17.1876
UL http://dx.doi.org/10.1001/archinte.167.17.1876
AB Background 
    Preventive health examinations (PHEs) are controversial, and limited data are available on their use and content.Methods 
    We conducted a retrospective analysis of 8413 ambulatory visits from January 1, 2002, to December 31, 2004, for PHEs and preventive gynecological examinations (PGEs) by adults in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Population estimates were obtained from the Current Population Survey. We estimated rates of PHEs and PGEs by patients' demographic characteristics, the frequency of 8 preventive services provided at these visits, and total costs of PHEs and PGEs at Medicare reimbursement rates.Results 
    An estimated 44.4 million adults per year (20.9%; 95% confidence interval [CI], 18.2%-23.6%) received a PHE, and 19.4 million women per year (17.7% of adult women; 95% CI, 14.9%-20.4%) received a PGE, together accounting for 8.0% of all ambulatory visits. The PHE rates varied by region (Northeast vs West: relative risk, 1.58; 95% CI, 1.17-2.14) and insurance type (those without vs those with private insurance or Medicare: relative risk, 0.51; 95% CI, 0.40-0.65). Preventive services occurred at 52.9% (95% CI, 48.8%-57.0%) of PHEs and 83.5% (95% CI, 80.7%-86.3%) of PGEs, but only 19.9% (95% CI, 18.4%-21.5%) of 8 preventive services occurred at a PHE or PGE. The annual costs of these visits were approximately $7.8 billion.Conclusions 
    PHEs and PGEs are among the most common reasons adults see a physician. These visits frequently include preventive services, but most preventive services are provided at other visits. These findings provide a foundation for continuing national deliberations about the use and content of PHEs and PGEs.