Priorities among recommended clinical preventive services1

Coffield, Ashley B; Maciosek, Michael V; McGinnis, J.Michael; Harris, Jeffrey R; Caldwell, M.Blake; Teutsch, Steven M; Atkins, David; Richland, Jordan H; Haddix, Anne

« Previous Next »American Journal of Preventive Medicine
Volume 21, Issue 1 , Pages 1-9, July 2001

Priorities among recommended clinical preventive services¹

Ashley B Coffield, MPA
- Partnership for Prevention (Coffield), Washington, DC, USA
- Address correspondence and reprint requests to: Ashley B. Coffield, MPA, Partnership for Prevention, 1233 20th Street, NW, Washington, DC 20036
Michael V Maciosek, PhD
- HealthPartners Research Foundation (Maciosek), Minneapolis, Minnesota, USA
J.Michael McGinnis, MD (MPP)
- Robert Wood Johnson Foundation (McGinnis), Princeton, New Jersey, USA
Jeffrey R Harris, MD, MPH
- Centers for Disease Control and Prevention (Harris, Caldwell), Atlanta, Georgia, USA
M.Blake Caldwell, MD
- Centers for Disease Control and Prevention (Harris, Caldwell), Atlanta, Georgia, USA
Steven M Teutsch, MD, MPH
- Merck & Co., Inc. (Teutsch), West Point, Pennsylvania, USA
David Atkins, MD, MPH
- Agency for Healthcare Research and Quality (Atkins), Rockville, Maryland, USA
Jordan H Richland, MPA, MPH
- American College of Preventive Medicine (Richland), Washington, DC, USA
Anne Haddix, PhD
- Emory University (Haddix), Atlanta, Georgia, USA

Abstract

Background: Many recommended clinical preventive services are delivered at low rates. Decision-makers who wish to improve delivery rates, but face competing demands for finite resources, need information on the relative value of these services. This article describes the results of a systematic assessment of the value of clinical preventive services recommended for average-risk patients by the U.S. Preventive Services Task Force.

Methods: The assessment of services’ value for the U.S. population was based on two dimensions: burden of disease prevented by each service and cost effectiveness. Methods were developed for measuring these criteria consistently across different types of services. A companion article describes the methods in greater detail. Each service received 1 to 5 points on each of the two dimensions, for total scores ranging from 2 to 10. Priority opportunities for improving delivery rates were determined by comparing the ranking of services with what is known of current delivery rates nationally.

Results: The highest ranked services (scores of 7+) with the lowest delivery rates (≤50% nationally) are providing tobacco cessation counseling to adults, screening older adults for undetected vision impairments, offering adolescents an anti-tobacco message or advice to quit, counseling adolescents on alcohol and drug abstinence, screening adults for colorectal cancer, screening young women for chlamydial infection, screening adults for problem drinking, and vaccinating older adults against pneumococcal disease.

Conclusions: Decision-makers can use the results to set their own priorities for increasing delivery of clinical preventive services. The methods provide a basis for future priority-setting efforts.

Keywords: cost-benefit analysis, delivery of health care, economics, healthcare quality, access, and evaluation, health policy, health priorities, preventive health services, preventive medicine, quality-adjusted life years