Clinical studyEffects of sustained audit/feedback on self-reported health status of primary care patients☆
Section snippets
Setting and patients
ACQUIP was conducted between March 1997 and December 1999 in the general internal medicine clinics at seven Veterans Affairs (VA) medical centers (Birmingham, Alabama; Little Rock, Arkansas; Richmond, Virginia; San Francisco, California; Seattle, Washington; West Los Angeles, California; and White River Junction, Vermont). Each had established discrete firms, teams, or practices staffed by different groups of physicians caring for different patients. At each site, one randomly selected firm
Results
Of 34,050 eligible patients, 22,413 returned baseline health inventories and were mailed follow-up surveys. Of these, 15,346 responded to at least one mailing of the SF-36 and condition-specific questionnaires, and 9019 completed 2 years of follow-up (Figure 3). Sixty percent (13,478/22,413) of baseline respondents returned follow-up, condition-specific surveys.
Of 895 participating providers, 153 (17%) were staff physicians, 654 (73%) were physicians-in-training, and 88 (10%) were nurse
Discussion
In this 2-year randomized trial, outcomes were not improved by a sustained and comprehensive program of feedback of patients' perceived health and function plus an educational program for providers. The study had several strengths, including a large, diverse sample, a multicenter design, and the ability to assess factors that may have contributed to response bias. The intervention incorporated the input of many users and was implemented with the assistance of respected leaders at each site.
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This study was supported by grants SDR 96-002 and IIR 99-376 from the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, with Institutional Review Board approval. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
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Deceased.