title: The short-term effect of patient health status assessment in a health maintenance organization.
abstract: This study was designed to test the short-term effects of health assessment on the process of care and patient satisfaction. The 29 Chart physicians used the Dartmouth COOP Charts to measure their adult patients' health status during a single clinical encounter; the 27 control clinicians used no measure of health status. We compared the change between baseline and post-intervention information for a sample of all study clinicians' patients. Most of the patients were female (67%), well educated (70% had at least a college education) and young (approximately 90% were aged 59 years or younger). We found that the ordering of tests and procedures for women was increased by exposure to the COOP Charts (52% vs. 35%; p < 0.01); the effect in men was not as significant (37% vs. 23%: p = 0.06). Although women reported no change in satisfaction with care, men claimed that the clinician helped in the management of pain (p = 0.02). We conclude that the use of health status measures during a single clinical encounter in an HMO changes clinician test ordering behaviour and may improve the help male patients receive for pain conditions. The long-term impact of these management changes is not known.
authors.affiliation: Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03755-3862.
authors.forename: J
authors.initials: J
authors.lastname: Wasson
authors.forename: R
authors.initials: R
authors.lastname: Hays
authors.forename: L
authors.initials: L
authors.lastname: Rubenstein
authors.forename: E
authors.initials: E
authors.lastname: Nelson
authors.forename: J
authors.initials: J
authors.lastname: Leaning
authors.forename: D
authors.initials: D
authors.lastname: Johnson
authors.forename: A
authors.initials: A
authors.lastname: Keller
authors.forename: J
authors.initials: J
authors.lastname: Landgraf
authors.forename: C
authors.initials: C
authors.lastname: Rosenkrans
mesh_terms: D017050:Episode of Care; D005260:Female; D005568:Forms and Records Control; D006279:Health Maintenance Organizations / Q000592:standards; D006304:Health Status; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000592:standards*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction