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Related Experiment Videos

Prolonging the return visit interval in primary care.

Gordon Schectman1, Gary Barnas, Prakash Laud

  • 1Division of Primary Care (PC-00), Milwaukee Veterans Affairs Medical Center, 5000 National Avenue, Milwaukee, WI 53226, USA gordon.schechtman@med.va.gov

The American Journal of Medicine
|April 6, 2005
PubMed
Summary

Extending patient return visit intervals can improve clinic access without sacrificing quality of care. An educational program successfully encouraged providers to lengthen intervals while improving preventive screenings and chronic disease management.

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Area of Science:

  • Primary Care
  • Health Services Research
  • Quality Improvement

Background:

  • Extending return visit intervals may enhance clinic access but could potentially compromise care quality.
  • Preventive measures and chronic disease management may be overlooked with less frequent visits.

Purpose of the Study:

  • To evaluate if a comprehensive education program can encourage primary care providers to extend return visit intervals.
  • To determine if extended intervals impact key quality indicators in chronic disease management and preventive care.

Main Methods:

  • Prospective cohort study at the Milwaukee Veterans Affairs Medical Center.
  • Providers received education and feedback to lengthen return visit intervals, increasing reliance on clinic staff for interim care.
  • Data on scheduling and clinical performance were collected via medical record audits at baseline and follow-up periods (2000-2001).

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Main Results:

  • Significant increase in patients scheduled for visits > or =6 months (Staff providers: 31% to 62%; Medicine residents: 22% to 44%).
  • Improvements observed in colorectal screening, pneumonia immunizations, and therapeutic goal achievement for diabetes, hypertension, and lipid disorders.
  • No compromise in key quality indicators despite extended visit intervals.

Conclusions:

  • Educational interventions effectively retrain providers to extend return visit intervals, reducing unnecessary appointments.
  • Extended visit intervals can be implemented without negatively impacting essential performance measures for chronic conditions and preventive care.