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

• Published in: Scandinavian journal of public health Vol. 35; no. 4; pp. 365 - 372
• Main Authors: RASMUSSEN, SUSANNE R., THOMSEN, JANUS L., KILSMARK, JANNIE, HVENEGAARD, ANNE, ENGBERG, MARIANNE, LAURITZEN, TORSTEN, SØGAARD, JES
• Format: Journal Article
• Language: English
• Published: London, England Taylor & Francis 01.01.2007; Sage Publications; Sage
• Subjects: Adult; Biological and medical sciences; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Consultation; Cost effectiveness; Cost-Benefit Analysis; Denmark - epidemiology; Family Practice - economics; Female; Follow-Up Studies; Health; Health Care Costs; Health Promotion - economics; Humans; Life Expectancy; Life Style; Male; Mass Screening - economics; Medical sciences; Middle Aged; Middle aged people; Miscellaneous; ORIGINAL ARTICLES; Physical Examination - economics; Prevention and actions; Preventive health care; Preventive Health Services - economics; Primary Health Care - economics; Public health. Hygiene; Public health. Hygiene-occupational medicine; Surveys and Questionnaires; Denmark; primary health care; Healthcare costs; healthcare effect; randomized controlled trial; Costs; Life expectancy; Primary health care; Increase; Medical screening; Prevention; Randomization; Health economy; Consultation; Randomised controlled trial; Clinical trial; Economic aspect; Public health
• ISSN: 1403-4948; 1651-1905
• DOI: 10.1080/14034940701219642

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 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.