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Preventive service delivery: a new insight into French general practice

Abstract : OBJECTIVE: The importance of prevention is increasingly recognised in most developed countries. General practitioners (GPs) have got a key role to play in this domain in primary care. But, the research evidence still concludes that GPs' preventive activities remain most of the time insufficient. The Aim : of our study was to contribute to this debate in adopting a more broad view of prevention-related activities to better understand the GPs practice in this matter. Our study was undertaken to measure the part of prevention-related activity hidden in each of the morbid conditions (MC) seen by the doctors daily. METHODS: We carried out a cross-sectional study in a sample of 75 French GPs in the south suburb of Paris. We dropped the usual pre-established and limited list of specific preventive care activities to replace it with a list of 100 most common morbid conditions seen by the GPs in daily practice. The GPs were asked for each selected MC to rate on a five-item Likert scale the amount of primary and secondary prevention they generally offer during a patient visit. RESULTS: All MC confounded, secondary prevention reached an average score of 3.2 (inter-quartile interval 2.82-3.58). The intensity of primary prevention was somewhat lower, but far from being negligible. Its average score was 2.3 (inter-quartile interval of 1.86-2.73). If more than 50% of the GPs declare a low intensity of primary prevention activity or even no primary prevention activity at all in nearly 3/4 of the MC encountered in their daily practice, they also declare that they carry out a considerable amount of primary prevention or in some cases spend the entire patient visit to primary prevention for MC covering more than 25% of their daily activity. Also, even if a majority of GPs did not give clear-cut scores for secondary prevention for 2/3 of the MC, they declare a considerable amount of it for the remaining 1/3 which covers more than 25% of their activity. CONCLUSION: Our study was useful to offer a more realistic view of the real place of the prevention-related activities in the GPs daily primary care practice even if we assess neither the appropriateness nor the quality of these activities.
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https://hal-cnrs.archives-ouvertes.fr/hal-03476934
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Submitted on : Monday, December 13, 2021 - 11:39:47 AM
Last modification on : Wednesday, December 15, 2021 - 2:37:48 PM

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Nathalie Pelletier-Fleury, Marc Le Vaillant, P Szidon, P Marie, F Raineri, et al.. Preventive service delivery: a new insight into French general practice. Health Policy, Elsevier, 2007, 83 (2-3), pp.268-276. ⟨10.1016/j.healthpol.2007.01.004⟩. ⟨hal-03476934⟩

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