title: Effect of preventive health screening on long-term primary health care utilization. A randomized controlled trial.
abstract: BACKGROUND
  Regular preventive health screenings are a feature of primary health care in several countries. Studies of the effect of regular preventive health checks have reported different results regarding primary health care utilization.
  
  
  OBJECTIVE
  To analyse the effect of preventive health screening and health discussions on contacts to general practice.
  
  
  METHODS
  A randomized controlled trial with all GPs in the district of Ebeltoft, Denmark. All middle-aged residents registered with a GP in the district of Ebeltoft were included (n = 3464). A random sample of 2030 subjects was selected for invitation to participate in health screening or health screening and discussions. The remaining 1434 subjects were never contacted and served as an external control group. Main outcome measure was number of daytime consultations in general practice.
  
  
  RESULTS
  The annual rate ratios for daytime consultations showed a very clear time trend (P < 0.0001) with a high rate of contacts among invited compared with non-invited subjects during the first year (P = 0.001) followed by a gradual decrease to a lower level after eight years (P = 0.037). The total rate ratio for daytime consultations was 1.01 (95% CI 0.93 to 1.10).
  
  
  CONCLUSIONS
  We observed no differences between the invited group and the non-invited group in any type of contact to general practice when the entire follow-up period was considered. There was a significant trend in rate ratios for daytime consultations with an initial rise followed by a gradual decrease in rate ratios. More investigations are needed to confirm and explore reasons for this trend.
authors.affiliation: Department and Research Unit of General Practice, University of Aarhus, 8000 C Aarhus, Denmark. jlt@alm.au.dk
authors.forename: J L
authors.initials: JL
authors.lastname: Thomsen
authors.forename: E T
authors.initials: ET
authors.lastname: Parner
authors.forename: B
authors.initials: B
authors.lastname: Karlsmose
authors.forename: A M
authors.initials: AM
authors.lastname: Thulstrup
authors.forename: T
authors.initials: T
authors.lastname: Lauritzen
authors.forename: M
authors.initials: M
authors.lastname: Engberg
mesh_terms: D000328:Adult; D003718:Denmark; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000706:statistics & numerical data*; D005194:Family Practice / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D016012:Poisson Distribution; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome