Amoroso Cheryl, Harris Mark F, Ampt Amando, Laws Rachel A, McKenzie Suzanne, Williams Anna M, Jayasinghe Upali W, Zwar Nicholas A, Powell Davies Gawaine
Centre for Primary Health Care and Equity, University of New South Wales.
Aust Fam Physician. 2009 May;38(5):358-62.
The 45 year old health check (MBS item 717) for patients aged 45-49 years was introduced in 2006. This study evaluated its impact on preventive care and patient reported risk factors.
A quantitative and qualitative study was conducted in eight general practices in Sydney, New South Wales. It involved follow up surveys of 118 patients taken both before the check and 3 months after. Practice staff were trained and supported to conduct the health checks and appropriate interventions.
There was ambivalence among some of the general practitioners toward the health check, but most found it feasible. The reported frequency of GP advice relating to each of the SNAP (smoking, nutrition, alcohol, and physical activity) risk factors increased; patient referrals, however, were infrequent. Patients' readiness to change their diet and exercise habits improved as a result of the check, with respondents showing an increase in both the consumption of vegetables and the frequency of physical activity. There was no change in body mass index, smoking or alcohol consumption.
The health check was associated with a short term improvement in diet and physical activity behaviours. Mechanisms to enhance referral need to be developed.
45岁健康检查(医疗保险福利计划项目717)于2006年开始适用于45至49岁的患者。本研究评估了其对预防保健以及患者报告的风险因素的影响。
在新南威尔士州悉尼的8家普通诊所开展了一项定量和定性研究。研究包括对118名患者在检查前和检查后3个月进行随访调查。对诊所工作人员进行了培训并提供支持,以开展健康检查及适当的干预措施。
一些全科医生对健康检查持矛盾态度,但大多数人认为其可行。报告显示,与SNAP(吸烟、营养、酒精和身体活动)各风险因素相关的全科医生建议频率有所增加;然而,患者转诊并不常见。检查后,患者改变饮食和锻炼习惯的意愿有所提高,受访者的蔬菜摄入量和身体活动频率均有所增加。体重指数、吸烟或饮酒量没有变化。
健康检查与饮食和身体活动行为的短期改善有关。需要制定加强转诊的机制。