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Surge in preventive care visits over two decades holds promise for patient-physician relationships


Preventive visits nearly doubled between 2001 and 2019

Patient-physician relationships could be on the rise: ©Goodluz -

Patient-physician relationships could be on the rise: ©Goodluz -

A study published in Health Affairs reveals a substantial increase in preventive care visits within the United States over the past two decades, signaling a positive trend for patient-physician relationships and overall health care outcomes. The research, based on a cross-sectional study of adult primary care visits, found that the proportion of visits focused on preventive services nearly doubled from 12.8% in 2001 to 24.6% in 2019.

The study, led by Lisa Rotenstein, M.D., a primary care physician at the Center for Primary Care at Harvard Medical School, analyzed data from the National Ambulatory Medical Care Survey. The increase in preventive visits was observed across all age groups and insurance types, including private insurance, Medicaid, self-pay, and workers' compensation. Notably, Medicare beneficiaries exhibited the largest increase, up 10 percentage points over the two-decade span.

The surge in preventive visits is attributed to policies enacted under the Affordable Care Act, making preventive exams a unique visit type with no copay for Medicare and most other insurance plans. The data indicated a spike in preventive visits for patients aged 18 to 44 years shortly after the law was passed. However, Rotenstein notes that other factors within the health care system could have influenced the impact of these policies.

The study also highlighted that physicians spent significantly more time with patients during preventive visits compared to problem-based visits. Physicians were more likely to provide counseling, order preventive labs, or recommend a preventive image or procedure during these exams. The extended time during preventive visits allows for a deeper understanding of patients' social determinants of health, ultimately aiding in care decisions.

Beyond the medical benefits, the study underscores the positive impact of preventive visits on physician-patient relationships. Longitudinal relationships between doctors and patients have been linked to lower patient costs and hospitalizations, contributing to improved overall health care outcomes.

The study's limitation is that it only evaluated trends through 2019, and the impact of the COVID-19 pandemic on primary care access and preventive visits remains to be seen. Dr. Greiner emphasizes the importance of continued monitoring to understand whether the surge in preventive visits will persist in the coming years.

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Jennifer N. Lee, MD, FAAFP
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