Rates of Delivering Preventive Services Before and After Outreach Program Implementation, Grouped by Service Type and Care Delivery Domain
| Preventive Service Type | Baseline Service Rate* | Intervention Service Rate* | P | Share of Total ROI† |
|---|---|---|---|---|
| Primary care practice domain | ||||
| Smoking cessation counseling | 33% | 71% | <.01 | 14% |
| Adult immunizations (influenza and pneumococcal vaccine) | 63% | 78% | <.05 | 3% |
| Diabetes management (diabetes checkup visits & HbA1c measurement) | 48% | 75% | <.01 | 18% |
| Well child visits | 51% | 60% | <.05 | 13% |
| Physical activity counseling | 27% | 38% | <.01 | 14% |
| All practice-based services | 44% | 64% | <.01 | 62% |
| County hospital and health system domain | ||||
| Colonoscopy (referred) | 38% | 43% | .07‡ | 31% |
| Mammography (referred) | 55% | 63% | <.05 | 6% |
| Bone density screening (referred) | 24% | 30% | <.05 | 1% |
| All referred services | 39% | 45% | .05 | 38% |
| County healthcare domain | ||||
| All services combined | 42% | 57% | <.01 | 100% |
↵* Service rates were measured by combining HIE record analyses and medical record abstractions. HIE records and health system-level service reports were essential to estimate the rate of referred services (mammography, colonoscopy, and bone density screening).
↵† Total ROI includes all returns generated across the project, including all organizations and services.
↵‡ Although this trend did not reach statistical significance across the county, there was an increase in the absolute number of colonoscopies that were referred to the health system that employed the wellness coordinator during the intervention period compared to the baseline period. Most of these patients received a call from the wellness coordinator.