Primary care visits for preventive services have nearly doubled since 2001, and new research suggests these visits increase the valuable time clinicians and patients spend together.
Results from a cross-sectional study of adult primary care visits show that the proportion of preventive service-focused visits to primary care increased from 12.8% in 2001 to 24.6% in 2019. published This month is health issues.
This increase continued over time across all age groups and insurance types, including private insurance, Medicaid, self-pay, and workers’ compensation. Medicare beneficiaries had the largest increase in preventive visits, increasing by 10 percentage points over 20 years.
This increase is likely related to policies enacted under the Affordable Care Act. With this policy, preventive testing has become a unique home-visit type with no out-of-pocket costs. medicare and Most other insurance plans, according to the researchers. Data shows that immediately after the law was passed, preventive visits for patients between the ages of 18 and 44 skyrocketed.
But “other factors in the health care system may have reduced the impact of the policy,” said Lisa Rothenstein, a primary care physician at the Harvard Medical School Primary Care Center in Boston and the study’s lead author. the doctor said.
National trends show that There are fewer Americans While there are primary care clinicians, these specialists are seen less frequently than in past decades. Additionally, the primary care workforce is contractionEven though more nurses and physician assistants are joining the specialty.
“I’m surprised and pleased,” said Anne Greiner, president of the Primary Care Coalition, an organization working to expand access to primary care.
nevertheless the study in health problems Although they did not examine overall trends in primary care visits, the researchers highlighted several findings from previous studies that showed a decline in primary care visits. The survey also found that fewer adults have access to regular primary care.
“We know that primary care visits are down, and that’s where preventive care is happening,” Greiner said.
This new study, using data from the National Ambulatory Care Survey, shows that physicians spend significantly more time with patients during preventive visits compared to problem-based visits.
Physicians were also significantly more likely to counsel patients during these tests, order preventive tests, and order preventive imaging or treatments. Nurse visits or physician assistant visits were not included in the study.
Dr. Christina Bright, a primary care physician at Nortons Medical Group in Louisville, Kentucky, says a physical exam typically takes 30 to 40 minutes, but an emergency visit can take just 10 to 15 minutes. Stated.
“When they come in for their preventive visits, that’s when we really understand the social determinants of health,” Bright said.
During this long time discussing patients’ health risks, preferences, and daily routines, Bright begins to see red flags that might have been missed during a 10-minute acute care appointment, which helps inform treatment decisions. Masu.
in addition, Established benefits Extended preventive care improves the doctor-patient relationship, Rothenstein said. The longitudinal relationship between doctor and patient is tied to: Reduce patient costs and hospitalizations.
“Using preventive care as a stopgap for chronic disease should be one of our main goals,” says Dr. Diane Tieris, a family nurse practitioner in Columbia, Kentucky.
For the past 20 years of her 35-year career, she said, she has been able to allocate more time to these visits while still being well compensated. In the spring of 2023, she began offering home health visits for Medicare enrollees.
Over the past 20 years, preventive care visits have “definitely been on the rise, which is long overdue,” Thierry said. Medscape Medical News. Until then, my visits focused on the main complaint of the day.
However, the increase in preventive visits may also reflect the fact that patients are seeking other specialists for a variety of illnesses.
“Some simple problem-based visits actually drive some people away from primary care,” says Tim Anderson, MD, MAS, a primary care physician and health services researcher at the University of Pittsburgh. Stated. “This result may indicate the migration of ear infections and sore throats to urgent care or pharmacy-based clinics, for example.”
Emergency medicine doctors typically don’t have medical records or patient histories, but this setting could be more accessible and convenient, Greiner said.
One limitation of this study is that it only assessed trends through 2019. High stress on primary care clinicians And access to this care is limited.
“Will the increase in preventive visits continue? We need to track and see,” Greiner said.
This research was supported independently. Rothenstein and Maffei report no relevant financial relationships. Mr. Landon reported receiving consulting fees or payments from Freedman Healthcare Consulting, American Board of Internal Medicine, RTI, Inc., UptoDate, Upstream, and his CVS.
Donavyn Coffey is a freelance science and health reporter.You can see more of her work here.
