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Delivery of Preventive Services to Adults Aged 50–64: Monitoring Performance Using a Composite Measure, 1997–2004

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Summary

Objective

Population-based rates for the delivery of adult vaccinations or screenings are typically tracked as individual services. The current approach is useful in monitoring progress toward national health goals but does not yield information regarding how many U.S. adults receive a combination of preventive services routinely recommended based on a person’s age and gender. A composite measure is important for policymaking, for developing public health interventions, and for monitoring the quality of clinical care. During the period under study, influenza vaccination was newly recommended (2000) to be routinely delivered to adults in this age range. The objective of the study was to compare the delivery of routine clinical preventive services to U.S. adults aged 50–64 years between 1997 and 2004 using a composite measure that includes cancer screenings and vaccinations.

Design

Data were collected via telephone surveys in 1997, 2002, and 2004 as part of the Behavioral Risk Factor Surveillance System.

Participants

The participants were randomly selected adults aged 50–64 years in the 50 states and the District of Columbia in the selected years. Sample sizes ranged from 24,917 to 77,244.

Measurements and Main Results

The composite measure includes screening for colorectal cancer, cervical cancer, breast cancer, and vaccination against influenza (2002 and 2004 only). The composite measure quantifies the percentage of adults who are up-to-date with the complete set according to recommended schedules. With the inclusion of newly recommended influenza vaccination, the percentage of men and women aged 50–64 who were up-to-date on all selected measures in 2004 was 23.4% and 23.0%, respectively, compared with 37.6% and 30.5% in 1997. Without including influenza vaccination, the percentage of up-to-date adults aged 50–64 would have risen in 2004 to 50.5% (men) and to 44.7% (women). For both sexes, results varied by education, race/ethnicity, marriage status, insurance status, health status, and state.

Conclusion

In 2004, the percentage of adults aged 50–64 years receiving routinely recommended cancer screenings and influenza vaccination was low with fewer than 1 in 4 being up to date.

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Acknowledgment

The authors thank Lynda Anderson, Ph.D., Michel Alderman, M.D., and David Nelson, M.D., M.P.H., for their review of earlier drafts of this article. Funding for this research was provided by the CDC.

Conflict of Interest

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the CDC.

Author information

Authors and Affiliations

  1. Sickness Prevention Achieved through Regional Collaboration (SPARC), Lakeville, CT, USA

    Douglas Shenson MD, MPH, MS

  2. On Target Health Data LLC, Hartford, CT, USA

    Mary Adams MPH

  3. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

    Julie Bolen PhD, MPH

Authors
  1. Douglas Shenson MD, MPH, MS
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  2. Mary Adams MPH
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  3. Julie Bolen PhD, MPH
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Corresponding author

Correspondence to Douglas Shenson MD, MPH, MS.

Electronic supplementary material

Below is the link to the electronic supplementary material.

11606_2008_555_MOESM1_ESM.doc

Online Appendix Table 1 Prevalence of being up-to-date (UTD)* for men age 50–64 years, by state, Behavioral Risk Factor Surveillance System (BRFSS) 1997, 2002, 2004† (DOC 202 kb)

11606_2008_555_MOESM2_ESM.doc

Online Appendix Table 2 Prevalence of being up-to-date (UTD)* for women age 50–64 years, by state, Behavioral Risk Factor Surveillance System (BRFSS) 1997, 2002, 2004† (DOC 134 kb)

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Shenson, D., Adams, M. & Bolen, J. Delivery of Preventive Services to Adults Aged 50–64: Monitoring Performance Using a Composite Measure, 1997–2004. J GEN INTERN MED 23, 733–740 (2008). https://doi.org/10.1007/s11606-008-0555-7

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  • DOI: https://doi.org/10.1007/s11606-008-0555-7

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