Understanding the Value of the Wellness Visit: A Descriptive Study

Area of Science:

• Preventive Medicine
• Primary Care
• Health Services Research

Background:

• Clinical preventive services significantly reduce mortality and morbidity, yet recommended care uptake remains suboptimal in the US.
• Wellness visits offer a dedicated time for clinician-patient dialogue on health needs, but their direct impact on health outcomes is not well-established.
• Understanding the content and delivery of care during wellness visits is crucial for optimizing their effectiveness.

Purpose of the Study:

• To investigate the types of discussions and the volume of clinical preventive services delivered during primary care wellness visits.
• To identify new diagnoses resulting from the delivery of clinical preventive services during these visits.

Main Methods:

• A mixed-methods approach analyzing electronic health records and audio recordings of wellness visits.
• Inclusion of 1,008 patients and 22 primary care clinicians across three states (2018-2019).
• Measurement of clinical preventive service discussions and delivery aligned with U.S. Preventive Services Task Force recommendations.

Main Results:

• An average of 6.9 to 7.7 clinical preventive service discussions occurred per visit.
• While 80% of patients were up-to-date on some services 3 months post-visit, only 0.5% met all recommendations.
• An average of 0.4 new diagnoses, including cancers and cardiovascular risks, were identified per patient.

Conclusions:

• Wellness visits are vital opportunities for preventive care discussions and the identification of previously unrecognized health issues.
• Enhancing the delivery and uptake of recommended clinical preventive services during wellness visits can improve patient health.
• Policies and incentives supporting wellness visits are essential, particularly for underserved populations.