Thomsen Janus L, Karlsmose Bo, Parner Erik T, Thulstrup Ane M, Lauritzen Torsten, Engberg Marianne
Department and Research Unit of General Practice, University of Aarhus, Denmark.
Scand J Public Health. 2006;34(3):254-61. doi: 10.1080/14034940500307564.
To analyze the consequence of preventive health screenings and discussions on the utilization of secondary healthcare.
All 30- to 49-year-old residents registered with a general practitioner in the district of Ebeltoft, Denmark, were included (n = 3,464) in a randomized controlled trial with eight years' follow-up. A random sample of 2,030 subjects was selected for invitation (Invited). The remaining 1,434 persons were never contacted and served as external control group (Non-Invited). Persons accepting participation were randomly divided into one internal control group (Questionnaire) and two intervention groups. One intervention group was offered three health screenings (Health Screening) during the five years. The other intervention group were in addition offered a yearly health discussion with their general practitioner (Health Screening and Discussion).
The rate ratio for hospital admissions was 0.97 (95% confidence interval 0.80 to 1.18) in the Invited group compared with the Non-Invited. The annual admission rates showed a significant trend (p = 0.0003) with a decrease four and five years after intervention launch for the Invited group compared with the Non-Invited. A similar trend was found when comparing the internal control group with intervention groups (p = 0.0016).
A 30- to 49-year-old general population's utilization of secondary healthcare did not increase in response to a general health promotion offer. During the observation period a significant decline in annual hospital admission rates was seen.
分析预防性健康筛查及相关讨论对二级医疗保健利用情况的影响。
纳入丹麦埃贝尔托夫特地区所有在全科医生处注册的30至49岁居民（n = 3464），进行一项为期八年随访的随机对照试验。随机抽取2030名受试者进行邀请（受邀组）。其余1434人从未被联系，作为外部对照组（未受邀组）。接受参与的人员被随机分为一个内部对照组（问卷调查组）和两个干预组。一个干预组在五年内接受三次健康筛查（健康筛查组）。另一个干预组除接受健康筛查外，每年还与他们的全科医生进行一次健康讨论（健康筛查与讨论组）。
受邀组与未受邀组相比，住院率的比值比为0.97（95%置信区间0.80至1.18）。与未受邀组相比，受邀组在干预开始后的第四年和第五年，年住院率呈现出显著下降趋势（p = 0.0003）。将内部对照组与干预组进行比较时也发现了类似趋势（p = 0.0016）。
30至49岁的普通人群对二级医疗保健的利用并未因一般性健康促进措施而增加。在观察期内，年住院率出现了显著下降。
