Manuti et al. BMC Public Health 2010, 10:350 http://www.biomedcentral.com/1471-2458/10/350 R E S E A R C H A R T I C L E Open Access The quality of preventive health care delivered to adults: results from a cross-sectional study in Southern Italy Benedetto Manuti, Paolo Rizza, Aida Bianco*, Carmelo GA Nobile, Maria Pavia Abstract Background: It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients. Methods: In a cross-sectional study adults aged 18 years and over attending primary care physician (PCP) offices located in Southern Italy were interviewed from June through December 2007. Quality indicators of preventive health care developed from RAND’s Quality Assessment Tools and Behavioral Risk Factor Surveillance System (BRFSS) were used. Multivariate analysis was performed to identify and to assess the role of patients’ characteristics on delivery of clinical preventive services. Results: A total of 1467 subjects participated in the study. Excepting blood pressure preventive check (delivered to 64.4% of eligible subjects) and influenza vaccination (recommended to 90.2% of elderly), the rates of delivery of clinical preventive services were low across all measures, particularly for screening and counseling on health habits. Rates for providing cancer screening tests at recommended times were 21.3% for colonoscopy, 51.5% for mammography and 52.4% for Pap smear. Statistical analysis showed clear disparities in the provision of clinical preventive services associated with age, gender, education level, perceived health status, current health conditions and primary care access measures. Conclusions: There is overwhelming need to develop and implement effective interventions to improve delivery of routine clinical preventive services. Background Scientific consensus holds that the provision of clinical preventive services to adults can identify and detect many causes of adult mortality. Despite the fact that pre- vention is a core component of primary care practice, there is widespread evidence that clinical preventive ser- vice delivery rates are low and generally sub-optimal [1]. To assess the extent to which the healthcare system succeeds in providing essential clinical preventive ser- vices, composite measures have been developed. Among these measures, the RAND’s Quality Assessment Tools system has been extensively used to assess the quality of * Correspondence: a.bianco@unicz.it Chair of Hygiene, Medical School, University of Catanzaro “Magna Græcia”, Catanzaro, Italy certain preventive services which are routinely recom- mended for adults regarding screening and counseling on health habits, physical examination, vaccinations and screening for cancers [2]. Previous studies in USA have found significant disparities in the provision of these clinical preventive services, and these disparities are associated with the patients’ characteristics, such as sex, age, race or ethnic group, income and health insurance [3-6]. In Italy, where universal and free access to interven- tions included in the Basic Healthcare Parameters is provided through the National Health Service (NHS), financial resources for prevention are very limited; furthermore, preventive healthcare that is provided by Prevention Departments and primary care physicians (PCPs), is often not properly organized. Moreover, © 2010 Manuti et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.