The Short-Term Effect of Patient Health Status Assessment in a Health Maintenance Organization

Published in: Quality of Life Research, v. 1, no. 2, Apr. 1992, p. 99-106

Posted on RAND.org on January 01, 1992

by John Wasson, Ron D. Hays, Lisa V. Rubenstein, Eugene C. Nelson, Jennifer Leaning, Deborah Johnson, Adam Keller, Jeanne M. Landgraf, Carla M. Rosenkrans

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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. The authors 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). The authors 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..

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