Primary-care quality improvement of mammography rates: a baseline study

In order to improve mammography screening rates, a primary-care physician group in Hartford County studied mammogram compliance rates, and reasons for noncompliance, in a group of 722 women, aged 50 to 64 years.

During the two-year study period, 598 (82.8%) of the patients had a mammogram and 16 were lost to follow-up. Of the 108 women without mammograms, six did not think that one was recommended. The test was not indicated for four. Forty did not follow through with recommendations, nine avoided mammograms out of fear, and 11 refused mammograms or physician visits. Thirty-seven others had a mammogram scheduled or performed during the next year.

Several hypothetical strategies for improving compliance are suggested by these results: computer notification of patients of upcoming and overdue due dates, supportive exploration of patients' resistances and fears, phone reminders from primary care physician offices, preventive medicine "tickler files," and coordination across specialties.