A randomized trial of the use of patient self-assessment data to improve community practices.
OBJECTIVE
Because of time constraints in the office environment, problems of concern to elderly patients may not be raised during clinic visits. To facilitate communication about geriatric health problems, we examined the impact of a strategy that used patient self-assessment data to improve community practices.


METHODS
Twenty-two primary care practices were randomized to participate in the intervention strategy (intervention practices) or to provide usual care (usual care practices).


METHODS
Primary care practices in 16 towns in New Hampshire (total, 45 physicians).


METHODS
1651 patients 70 years of age or older.


METHODS
All patients received a mailed survey that asked about their health problems and about how well these problems were being addressed by their physicians. In the intervention practices, these data were used to generate a customized letter that directed the patient to specific sections in an 80-page modified version of the National Institute on Aging's Age Pages and were summarized and communicated to the patient's physician.


METHODS
Change from baseline in patients' overall assessment of health care.


RESULTS
In 8 of 11 intervention practices, patients felt that their care had improved over the 2-year study period. This improvement occurred in only 1 of 11 usual care practices (P = 0.003). Patients in intervention practices reported receiving significantly more help with physical function, fall prevention, and assistance for memory problems. Self-assessed health status did not differ in the two groups.


CONCLUSIONS
A standard, easy-to-implement strategy to improve the quality of provider--patient interactions can improve the satisfaction of older patients cared for in community practices.
Wasson
J H
JH
Center for the Aging, Dartmouth Medical School, Hanover, NH, USA.
Stukel
T A
TA
Weiss
J E
JE
Hays
R D
RD
Jette
A M
AM
Nelson
E C
EC
D000368:Aged; D005194:Family Practice / Q000592:standards*; D005246:Feedback; D005260:Female; D015577:Geriatric Assessment; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009513:New Hampshire; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D012647:Self-Assessment