[Factors promoting follow-up services after medical examinations by municipal governments].
OBJECTIVE
All Japanese municipal governments have a responsibility to conduct a medical examination for their residents aged 40 or more under the Health Services for the Elderly Act since 1984. According to the results of the medical examination, municipal governments should give appropriate follow up services to all users. The objective of this study was to find the factors promoting follow up services after medical examinations conducted by municipal governments.


METHODS
Mailed questionnaire surveys on follow up services after medical examination were sent out to all 3,255 municipal governments in Japan. The 2,447 municipal governments that answered all items on the questionnaire were enrolled in this study. Follow-up services by municipal government for persons with abnormal findings at medical examinations included "Suggestion to have a more detailed examination", "Confirmation of having had a detailed examination", "Individual health consultation", and "Home visit for medical guidance". These follow-up services were analysed in terms of the number of public health nurses per population and whether a continuous data set was maintained for medical examinations.


RESULTS
Follow-up services were conducted more frequently in municipalities that maintained continuous data sets of medical examination than those that did not. They were also carried out more frequently in municipalities with higher numbers of health visitors per population than in those with lower numbers. The percentage of municipal governments that maintained continuous data of medical examinations was higher among those that conducted group medical examinations than those that conducted individual medical examinations at local medical facilities.


CONCLUSIONS
Follow-up services after medical examinations by municipal governments showed a significant relationship with maintenance of a continuous data set of medical examinations and the number of public health nurses.
Fukuda
Hideki
H
Department of Social and Environmental Health, Graduate School of Medicine, Osaka University.
Shinsyo
Fumiaki
F
Takatorige
Toshio
T
Nakanishi
Noriyuki
N
Tatara
Kozo
K
D000368:Aged; D003153:Community Health Services; D006299:Health Services for the Aged; D006801:Humans; D007564:Japan; D009111:Local Government; D008499:Medical Records; D010808:Physical Examination; D011637:Public Health Nursing; D011795:Surveys and Questionnaires; D000078329:Workforce