BMJ. 1991 May 4;302(6784):1057-60. doi: 10.1136/bmj.302.6784.1057.
To describe the outcome of offering health checks systematically to a general practice adult population, in terms of age and sex specific prevalence of risk factors, follow up workload, and selective screening of cholesterol concentration.
Descriptive analysis of data obtained by postal questionnaire and by personal interview and clinical examination by a trained nurse.
2205 patients aged 35-64 who attended for a health check in 1989-90 from an invited random sample of 2777 patients from five urban general practices in Bedfordshire.
Overall, almost three quarters of patients (78% of men, 68% of women) needed specific advice or follow up. Smoking, a high fat diet, and being overweight (body mass index greater than or equal to 25 kg/m2) were common characteristics exhibited by 35%, 31%, and 55% respectively of men and 24%, 18%, and 48% of women. The total cholesterol concentration was greater than or equal to 6.5 mmol/l in 37% of patients and greater than or equal to 8 mmol/l in 8%. In terms of workload 13% needed dietary advice only, 15% needed only follow up of hyperlipidaemia or hypertension, and 9% needed advice on smoking only. A further 35% needed follow up for a combination of risk factors. The proportion of patients in whom cholesterol concentration would be measured if a selective screening policy were adopted would vary from 29% to 71%, according to different criteria, but (particularly in men) no combination would be much better than random testing as a means to detect patients with a total cholesterol concentration greater than or equal to 8 mmol/l.
If the entire adult population of a practice is offered health checks systematically the acceptance rate is lower and the follow up workload higher than previously understood. The resource implications depend on the age and sex of patients screened and the selective criteria adopted for cholesterol measurement. Health checks are only the beginning of a successful preventive programme--the challenge is to provide effective intervention and follow up.
从危险因素的年龄和性别特异性患病率、随访工作量以及胆固醇浓度的选择性筛查方面，描述对普通执业成人人群系统性提供健康检查的结果。
对通过邮政问卷、个人访谈以及由经过培训的护士进行临床检查所获得的数据进行描述性分析。
1989 - 1990年期间，从贝德福德郡五个城市普通执业诊所邀请的2777名患者的随机样本中，2205名年龄在35 - 64岁之间前来进行健康检查的患者。
总体而言，近四分之三的患者（78%的男性，68%的女性）需要特定建议或随访。吸烟、高脂肪饮食以及超重（体重指数大于或等于25kg/m²）是常见特征，分别有35%的男性、24%的女性，31%的男性、18%的女性以及55%的男性、48%的女性表现出这些特征。37%的患者总胆固醇浓度大于或等于6.5mmol/l，8%的患者大于或等于8mmol/l。在工作量方面，13%的患者仅需要饮食建议，15%的患者仅需要对高脂血症或高血压进行随访，9%的患者仅需要戒烟建议。另外35%的患者需要针对多种危险因素进行随访。如果采用选择性筛查策略，根据不同标准，测量胆固醇浓度的患者比例从29%到71%不等，但（尤其是在男性中）作为检测总胆固醇浓度大于或等于8mmol/l患者的手段，没有哪种组合比随机检测好很多。
如果对执业机构的全体成年人群系统性提供健康检查，接受率低于此前的认知，随访工作量高于此前的认知。资源需求取决于筛查患者的年龄和性别以及用于胆固醇测量的选择标准。健康检查只是成功预防计划的开端——挑战在于提供有效的干预和随访。
