title: The impact of seeing physicians new to a patient on the response to screening reminders.
abstract: BACKGROUND
  A large insurer in Hawaii mails annual reminders to its members regarding recommended health screenings. This study examined the associations between the characteristics of physicians visited after the reminders were sent and the health screenings received for breast, cervical, and colorectal cancers, and for diabetes and cholesterol.
  
  
  METHODS
  The study population included members identified as needing health screenings from 2000 to 2003 based on age and gender criteria. The study used a longitudinal design focusing on the 12 months after reminders were sent. Data were analyzed using logistic regression examining physician visits, other health services, and receipt of health screenings by 1-month intervals subsequent to the reminder mailings.
  
  
  RESULTS
  In adjusted, multivariable models, members who saw physicians they had not seen in the past year had odds ratios for obtaining health screenings 6 to 8 times higher than members who only saw previously visited physicians. This enhanced response occurred among members receiving their first, second, and third (or subsequent) annual reminder letter. The more physicians that were visited and who were new to the members, the more likely the members were to obtain health screenings.
  
  
  CONCLUSIONS
  Members seeing physicians they had not seen in the past year had significantly higher screening rates than the members only seeing physicians they had previously visited. The results suggest that healthcare screening may receive less attention at repeat visits with a physician than at visits with a physician who is new to a member.
authors.affiliation: Hawaii Medical Service Association (an independent licensee of the Blue Cross and Blue Shield Association), Honolulu, HI 96808-0860, USA. jun_zhu@hmsa.com
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: James
authors.initials: J
authors.lastname: Davis
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Taira
authors.forename: Marisa
authors.initials: M
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D005260:Female; D006254:Hawaii; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009819:Office Visits / Q000706:statistics & numerical data* / Q000639:trends; D017010:Reminder Systems