National Cancer Institute Home at the National Institutes of Health |
Please wait while this form is being loaded....
The Applied Research Program Web site is no longer maintained. ARP's former staff have moved to the new Healthcare Delivery Research Program, the Behavioral Research Program, or the Epidemiology & Genomics Research Program, and the content from this Web site is being moved to one of those sites as appropriate. Please update your links and bookmarks!

Publication Abstract

Authors: Nutting PA, Baier M, Werner JJ, Cutter G, Conry C, Stewart L

Title: Competing demands in the office visit: what influences mammography recommendations?

Journal: J Am Board Fam Pract 14(5):352-61

Date: 2001 Sep-Oct

Abstract: BACKGROUND: The multiple competing demands of the busy office visit have been shown to interfere with delivery of preventive services. In this study we used physician recommendations for screening mammography to examine the relative importance of physician, patient, and visit characteristics in determining on which patient visits this preventive service will be provided. METHODS: Physicians in the Ambulatory Sentinel Practice Network (ASPN) completed a questionnaire describing their knowledge, attitudes, and beliefs about screening mammography. They also described the content of a series of nonacute care visits with women aged 40 to 75 years with regard to making a recommendation when the patient was due for screening mammography. The data were linked, and univariate and multivariate logistic regression methods were used to examine the relative importance of physician, patient, and visit characteristics on making a recommendation for mammography. RESULTS: Ninety-three physicians reported making a recommendation for screening mammography on 53.1% of nonacute visits. When modeling physician, patient, and visit characteristics separately, 70% of the variability in the model is explained by physician characteristics only, 63% by patient characteristics only, and 73% by visit characteristics only. A combined model using all characteristics explained 85% of the variability. CONCLUSIONS: Although characteristics of physicians and patients can predict frequency of recommendations for mammography, the specific characteristics of the visit are equally important. Efforts to improve delivery of preventive services in primary care that emphasize physician education and performance feedback are unlikely to increase rates of mammography recommendation. Effective strategies must consider the multiple competing demands faced by patients and physicians during each office visit and seek ways for assisting them in setting rational priorities for services.

Last Modified: 03 Sep 2013