Research Activities, March 2014
AHRQ researchers find persistent differences in preventive services use within the U.S. population
Large differences in adult use of preventive services persisted from 1996 through 2008 across population groups defined by poverty, race/ethnicity, insurance coverage, and geography. AHRQ researchers, Salam Abdus, Ph.D., and Thomas M. Selden, Ph.D., analyzed data from the AHRQ Medical Expenditure Panel Survey for 1996/1998, 2002/2003, and 2007/2008 to examine trends in five preventive services: general checkups, blood pressure screening, blood cholesterol screening, Pap smears, and mammograms.
Among the population of nonelderly adults (ages 19–64 years), the proportion of the population having a general checkup increased 1.1 percentage points from 1996/1998 to 2007/2008; the proportion of those with blood cholesterol screening within the prior 5 years increased by 8.2 percentage points. In contrast, the percentage of the population having blood pressure screening or mammograms (among women) increased modestly between the first pair of time points, but remained essentially constant thereafter. Finally, the percentage of women having Pap smears increased modestly (by 2.1 percentage points) from 1996/1998 to 2002/2003, but decreased by about a percentage point subsequently to the end of the study period.
When comparing poor (below the Federal poverty level) and relatively high-income groups and white versus black or Hispanic groups, there were few significant changes over time. The same pattern was seen when comparing adults with and without coverage, except for blood cholesterol screening, where a significant narrowing of the gap between the privately insured and the uninsured occurred over the entire period (5.3 percentage points for uninsured adults). Regional differences persisted or widened over the study period. The researchers conclude that a key challenge facing the Affordable Care Act will be to address persistent differences in preventive services use.
More details are in "Preventive services for adults: How have differences across subgroups changed over the past decade?" by Drs. Abdus and Selden, in the November 2013 Medical Care 51(11), pp. 999-1007.