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Secondary healthcare contacts after multiphasic preventive health screening: A randomized trial

Department and Research Unit of General Practice, University of Aarhus, Denmark, janus.laust.thomsen{at}alm.au.dk

BO Karlsmose

Department and Research Unit of General Practice, University of Aarhus, Denmark

Erik T. Parner

Department of Biostatistics, University of Aarhus, Denmark

Ane M. Thulstrup

Department of Clinical Epidemiology, Aarhus University Hospital and Aalborg Hospital, Denmark

Torsten Lauritzen

Department and Research Unit of General Practice, University of Aarhus, Denmark

Marianne Engberg

Department and Research Unit of General Practice, University of Aarhus, Denmark

Aim: To analyze the consequence of preventive health screenings and discussions on the utilization of secondary healthcare. Methods: 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). Results: 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). Conclusions: 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.

Key Words: Controlled randomized trial • general practice • healthcare utilization • middle-aged • multiphasic screening • public health

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