Research Papers

Quality of Life Research

, Volume 1, Issue 2, pp 99-106

The short-term effect of patient health status assessment in a health maintenance organization

  • J. WassonAffiliated withDepartment of Community and Family Medicine, Dartmouth Medical School
  • , R. HaysAffiliated withRAND
  • , L. RubensteinAffiliated withDepartment of Medicine, Division of Geriatric Medicine, University of California at Los Angeles
  • , E. NelsonAffiliated withHospital Corporation of America
  • , J. LeaningAffiliated withHarvard Community Health Plan
  • , D. JohnsonAffiliated withDepartment of Community and Family Medicine, Dartmouth Medical School
  • , A. KellerAffiliated withDepartment of Community and Family Medicine, Dartmouth Medical School
  • , J. LandgrafAffiliated withDepartment of Community and Family Medicine, Dartmouth Medical School
  • , C. RosenkransAffiliated withHarvard Community Health Plan

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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.

Key words

Functional assessment health status