Use of Preventive Services in the United States: Estimates from 2015 MEPS Psaq Pilot Survey

Introduction: The U.S. Preventive Services Task Force (USPSTF) works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. The Affordable Care Act mandates that all private insurance plans provide coverage without patient co-payment of all USPSTF and Advisory Committee on Immunization Practices (ACIP) recommended services. Therefore, for people with private health insurance, payment should not be a barrier to access to these services. Research has also found that increasing the use of preventive health services can save lives. However, to date, it is unknown how many Americans are receiving the recommended preventive health services.

Methods: Cross-sectional analysis of a new Preventive Services Self-Administered Questionnaire (P-SAQ) that was fielded in a pilot as part of the 2015 Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey (MEPS) (n=2,186). MEPS is a nationally representative survey of the U.S. civilian noninstitutionalized population. The P-SAQ measures receipt of 16 recommended preventive health services for adults 35+ defined according to the recommendations of the USPSTF and ACIP. The survey was developed by AHRQ under the guidance of a National Steering Committee and underwent expert review, focus group testing of the survey section order, cognitive testing of the survey questions, and usability testing.

Results: Preliminary analyses found wide variation in receipt of recommended services. For example, most men and women age > 35 received blood pressure checks (89% (CI95: 87 – 90%)); and among those aged 35-74 most received cholesterol screening (83% (CI95: 80 – 85%)). However, other preventive services were less often received including, screening for depression among those > 35 (42% (CI95: 39 – 45%)); discussion of aspirin use to prevent heart attack or stroke among those aged 50-74 (47% (CI95 44- 51%)); and receipt of shingles vaccine among those > 65 (39% (CI: 35- 42%)).

Conclusions: The PSAQ provides initial national estimates of use of 16 recommended clinical preventive services. Future analyses will assess the proportion of adults who receive all recommended services for their age and sex. It will enable health practitioners and researchers to understand where the greatest health disparities exist in the population as well as for which preventive health services. This will facilitate targeted quality improvement to improve uptake preventive health services in the future.