Are physicians less likely to recommend preventive services to Low-SES patients?

Background. Do low-SES adult patients visiting private primary care clinics differ from higher SES adult patients in their need for eight preventive services or in receiving either a recommendation for or the needed services? Methods. Randomly identified adult patients were surveyed within 2 weeks of a visit to 22 clinics in the Minneapolis-St. Paul area. Questions assessed patient recollection of the latest receipt of eight services and whether needed services had been recommended during the visit or received then soon after. Results. Of those surveyed, 4,245 patients (1,650 low SES) responded (84.3%), showing that low SES patients were less likely to be up to date for cholesterol measurement, Pap smear, mammography, breast exam, and flu or pneumonia shots (P < 0.004), but not for blood pressure measurement. Low-SES patients needing services received recommendations to have them and actually received them at the same rate as higher SES patients. Conclusions. The 22 primary care clinics studied appear to be recommending and providing needed preventive services to visiting patients at the same rate regardless of income or insurance status. The reasons for differences in prevention status by SES are complex but the low proportion of all patients receiving recommendations for needed services suggests the need to take advantage of all visits for updating prevention needs.