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Preventive health screenings and health consultations in primary care increase life expectancy without increasing costs

DSI Danish Institute for Health Services Research, Copenhagen, Denmark, srr{at}dsi.dk

Janus L. Thomsen

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Jannie Kilsmark

DSI Danish Institute for Health Services Research, Copenhagen, Denmark

Anne Hvenegaard

DSI Danish Institute for Health Services Research, Copenhagen, Denmark

Marianne Engberg

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Torsten Lauritzen

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Jes Søgaard

DSI Danish Institute for Health Services Research, Copenhagen, Denmark

Aims: The intention was to investigate whether preventive health checks and health discussions are cost effective. Methods: In a randomized trial the authors compared two intervention groups (A and B) and one control group. In 1991 2,000 30- to 49-year-old persons were invited and those who accepted were randomized. Both intervention groups were offered a broad (multiphasic) screening including cardiovascular risk and a personal letter including screening results and advice on healthy living. Individuals in group A could contact their family physician for a normal consultation whereas group B were given fixed appointments for health consultations. The follow-up period was six years. Analysis was carried out on the ``intention to treat'' principle. Outcome parameters were life years gained, and direct and total health costs (including productivity costs), discounted by 3% annually. Costs were based on register data. Univariate sensitivity analysis was carried out. Results: Both intervention groups have significantly better life expectancy than the control group (no intervention). Group B and (A) significantly gain 0.14 (0.08) life years more than the control group. There were no differences in average direct (3,255 (3,703) versus 4,186) and total costs (10,409 (9,399) versus 10,667). The effect in group B is, however, better than in group A with no significant differences in costs. The results are insensitive to a range of assumptions regarding costs, effects, and discount rates. Conclusions: Preventive health screening and consultation in primary care in 30- to 49-year-olds produce significantly better life expectancy without extra direct and total costs over a six-year follow-up period.

Key Words: Healthcare costs • healthcare effect • primary health care • randomized controlled trial

Scandinavian Journal of Public Health, Vol. 35, No. 4, 365-372 (2007)
DOI: 10.1080/14034940701219642


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