Baker C, Loughren E A, Crone D, Kallfa N
University of Gloucestershire, Gloucester, Gloucestershire GL2 9HW, UK.
Public Health England, Bristol BS1 6EH, UK.
J Public Health (Oxf). 2015 Jun;37(2):202-9. doi: 10.1093/pubmed/fdv053. Epub 2015 Apr 28.
More evidence is needed concerning the implementation of the NHS Health Check programme in order to identify areas for improvement. The aim of the study was to investigate the way in which the Gloucestershire NHS Health Check programme care pathway was followed and interpreted compared with national programme indicators.
A cross sectional review of Gloucestershire's Health Checks was undertaken to assess programme performance via a primary care audit of key indicators within a cohort of 83 GP practices and an eligible population of 210 513. Data were assessed to compare differences between practices and to compare county data with national indicators.
The annual programme uptake was 49.8% and a total of 1031 patients were diagnosed with cardiovascular disease (CVD). Variations in the detection of modifiable risk factors in relation to the NHS Ready Reckoner were identified: diabetes (-0.04%), CKD (-0.9%), hypertension (-19.9%); obesity (-7.1%); low physical activity (-57.7%) and smoking (-14.3%).
Disparities in uptake and implementation of the care pathway demonstrate inconsistencies in the application of processes and knowledge. There appears to be an overestimation of CVD risk by the Ready Reckoner tool likely to be attributable to a failure to adjust for existing local early identification efforts in primary care and prevention.
为了确定需要改进的领域，需要更多关于国民保健服务（NHS）健康检查计划实施情况的证据。本研究的目的是调查格洛斯特郡NHS健康检查计划护理路径的遵循和解读方式，并与国家计划指标进行比较。
对格洛斯特郡的健康检查进行横断面审查，通过对83家全科医生诊所的关键指标进行初级保健审计以及对210513名符合条件的人群进行评估，以评估该计划的执行情况。对数据进行评估，以比较各诊所之间的差异，并将郡数据与国家指标进行比较。
年度计划参与率为49.8%，共有1031名患者被诊断患有心血管疾病（CVD）。在与NHS速算器相关的可改变风险因素检测方面发现了差异：糖尿病（-0.04%）、慢性肾脏病（-0.9%）、高血压（-19.9%）；肥胖症（-7.1%）；低体力活动（-57.7%）和吸烟（-14.3%）。
护理路径的采用和实施存在差异，表明在流程和知识应用方面存在不一致。速算器工具似乎高估了心血管疾病风险，这可能归因于未能对初级保健和预防中现有的地方早期识别工作进行调整。
