OBJECTIVE: To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs).
DESIGN: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.
SETTING: Southwestern Ontario.
PARTICIPANTS: A total of 232 physicians from 24 primary care network or family health network groups across 110 different sites eligible for pay-for-performance incentives.
INTERVENTIONS: The P-PROMPT project combined pay-for-performance incentives with provider and patient reminders and deployment of NPs to enhance the delivery of preventive care services.
MAIN OUTCOME MEASURES: The mean delivery rates at the practice level of time-appropriate mammograms and Papanicolaou tests completed within the previous 30 months.
RESULTS: Before-and-after comparisons of time-appropriate delivery rates (< 30 months) of cancer screening showed the rates of Pap tests and mammograms for eligible women significantly increased over a 1-year period by 6.3% (P < .001) and 5.3% (P < .001), respectively. The NP-augmented strategy achieved comparable rate increases to the automated strategy alone in the delivery rates of both services.
CONCLUSION: The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.
|Journal||Canadian Family Physician|
|Publication status||Published - Jun 2013|
- Breast Neoplasms
- Early Detection of Cancer
- Health Promotion
- Middle Aged
- Nurse Practitioners
- Patient Acceptance of Health Care
- Preventive Health Services
- Primary Health Care
- Program Evaluation
- Reimbursement, Incentive
- Reminder Systems
- Uterine Cervical Neoplasms
- Vaginal Smears
- Journal Article
- Research Support, Non-U.S. Gov't