How a university hospital improves its prevention performance: results of two biennial studies 2004-2006

Prevention is a legal obligation for French hospitals and should be systematically assessed.

To measure how a French University Hospital improved its prevention performance between two biennial prevention studies after incentives measures were applied.

45 medical, obstetrical or surgical units were included. A doctor-nurse pair was free to select inpatients at random. 14 preventive procedures were evaluated: blood pressure check, measures of weight, height and body mass index, screenings for diabetes, cervix and breast cancers, tetanus and influenza immunizations, serologies of viruses, research for a prostatic and cognitive disorder and evaluation of alcohol and tobacco consumptions and addictions. Incentives measures for prevention were enacted during the same time.

In 2004 and in 2006, respectively 253 inpatients and 243 inpatients were respectively included. Tetanus immunization was checked in less than one tenth of cases in both the studies. Seven acts were performed more in 2006 and only body mass index was measured less.

The results were encouraging but insufficient especially for tetanus immunization. Weight was measured more than body mass index, probably meaning that's weight and more precisely its variations are a better clinical sign. Bad results for tetanus immunization meant that incentive strategies only displayed within the hospital were ineffective. Lastly, two propositions were done to improve the questionnaire and the prevention performance: to add five preventive services and a medical file first page, common to all units, summing up all preventive procedures evaluated.

The ability of this University Hospital to improve its prevention performance answering to local incentive measures was weak. Another solutions need to be found.