Effect of an Educational Program on Inappropriate Uri Visits: A Randomized Controlled Study
Roberts, Carl Rodney
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https://hdl.handle.net/2142/67971
Description
Title
Effect of an Educational Program on Inappropriate Uri Visits: A Randomized Controlled Study
Author(s)
Roberts, Carl Rodney
Issue Date
1980
Department of Study
Health and Safety Education
Discipline
Health and Safety Education
Degree Granting Institution
University of Illinois at Urbana-Champaign
Degree Name
Ph.D.
Degree Level
Dissertation
Keyword(s)
Health Sciences, Education
Language
eng
Abstract
Excessive utilization of health care services is a major problem in a time of limited resources. One clinical area generating excess utilization is that of upper respiratory infection (URI). Such infections account for nine percent of all primary care visits nationwide. Examination of URI visits to the Family Medical Care Center (FMCC) at the University of Missouri-Columbia School of Medicine revealed that only half met criteria indicating a need for medical attention.
The purpose of this study was to determine the effect of an educational program on the number of such inappropriate URI visits made by families enrolled in the FMCC.
A selected group of patients receiving all their regular care at the FMCC, and who did not anticipate moving from the area for at least a year, participated in the study. A post-test control group design was used. Subjects were randomized into an education or a control group, with approximately 440 families in each. The education group received instructions on (1) the purpose of the educational program, (2) who could use the information, (3) symptoms of URI's, (4) what to do at home for someone with a URI, and (5) when to call a physician or nurse practitioner. URI visits generated by the study families were recorded for periods ranging from eleven to seventeen months, depending upon date of enrollment. These visits were reviewed by a panel of three persons, two M.D.s and one Ph.D., for appropriateness. Each reviewer was blind to group, and initially to rating, given by the other reviewers. Appropriate, inappropriate and total URI visits per person-year exposed were calculated for each family. The educated group exhibited a 44 percent reduction in inappropriate visit rate (p < .002) and a 30 percent reduction in total visit rate (p < .01). The observed difference in appropriate URI visit rates between the two groups was not statistically significant.
Nationwide there were over 78.5 million URI visits in 1975-76. If these URI visits were similar to those at the Columbia FMCC, then half were inappropriate and potentially 44 percent (over 17.2 million) could have been eliminated by educating patients. Health services providers look for ways to apply resources where most beneficial. This study demonstrated that educating the consumer on appropriate circumstances in which to seek medical care for URI's can ease the strain on the health care system.
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