The document summarizes adolescent preventive services and visit patterns. It finds that currently recommended clinical preventive services (CPS) for adolescents often lack strong evidence of effectiveness. Delivery rates of CPS are low, even for services with good evidence like cervical cancer screening. Adolescents average 1.9 total medical visits per year but only 9% are for preventive care. Guidelines calling for one annual preventive visit are met less than 2% of the time. More evidence and attention to improving delivery systems are needed to better provide preventive services to adolescents.

1. Adolescent Preventive Services James D. Nordin, MD, MPH Leif I. Solberg, MD HealthPartners Research Foundation Minneapolis, MN

3. I. Clinical Preventive Services for Adolescents

21. 2. Primary Care Visit Patterns

24. Cross Sectional Analysis Preventive Visit Rate by Year of Age

25. Cross Sectional Analysis Non Preventive Visit Rate by Year of Age

27. Longitudinal Analysis Male/Female Breakdown mean # of visits Female Male p-value preventive visits 1.2 1 <0.0001 non-preventive visits 7.7 5.9 <0.0001 mean visit rate per year preventive visits 0.3 0.2 <0.0001 non-preventive visits 1.7 1.3 <0.0001

28. Longitudinal Patterns of Health Care Use Among Adolescents Over 4 or More Years Number of visits Non preventive Com Non preventive Gvt P-value Preventive Com Preventive Gvt P-value 0 8% 15% 30% 30% 1 9% 13% 41% 36% 2 10% 10% 22% 21% 3 9% 9% 5% 9% 4 9% 8% 1% 2% 5 to 10 34% 25% 0% 0% >10 20% 20% 0% 0% Overall mean total visits 6.83 6.41 0.0277 1.07 1.18 <0.0001 mean per year 1.5 1.47 0.5702 0.23 0.27 <0.0001