Title

Differences in preventive health quality by residency year. Is seniority better

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

8-25-2005

Document Type

Article

Subjects

Adult; Colorectal Neoplasms; Counseling; Cross-Sectional Studies; Female; Humans; Internal Medicine; *Internship and Residency; Male; Mass Screening; Pediatrics; *Preventive Medicine; *Quality of Health Care; United States

Disciplines

Bioinformatics | Biostatistics | Epidemiology | Health Services Research

Abstract

BACKGROUND: It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively.

OBJECTIVE: To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training.

DESIGN: Cross-sectional study.

PARTICIPANTS: One hundred twenty Internal Medicine residents, postgraduate year (PGY)- 1 and PGY -2, attending a University Internal Medicine teaching clinic between June 2000 and May 2003.

MEASUREMENTS: We studied 6 preventive health care services offered or received by patients by abstracting data from 1,017 patient records. We examined the differences in performance between PGY-1 and PGY-2 residents.

RESULTS: Postgraduate year-2 residents did not statistically outperform PGY-1 residents on any measure. The overall proportion of patients receiving appropriate preventive health services for pneumococcal vaccination, advising tobacco cessation, breast and colon cancer screening, and lipid screening was similar across levels of training. PGY-1s outperformed PGY-2s for tobacco use screening (58%, 51%, P = .03). These results were consistent after accounting for clustering of patients within provider and adjusting for patient age, gender, race and insurance, resident gender, and number of visits during the measurement year.

CONCLUSIONS: Overall, patients cared for by PGY-2 residents did not receive more outpatient preventive health services than those cared for by PGY-1 residents. Efforts should be made to ensure quality patient care in the outpatient setting for all levels of training.

Rights and Permissions

Citation: J Gen Intern Med. 2005 Sep;20(9):825-9. Link to article on publisher's site

Journal/Book/Conference Title

Journal of general internal medicine

PubMed ID

16117750

Related Resources

Link to Article in PubMed