Preventive health screenings and health consultations in primary care increase life expectancy without increasing costs.
OBJECTIVE
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 euro (3,703 euro) versus 4,186 euro) and total costs (10,409 euro (9,399 euro) versus 10,667 euro). 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.
Rasmussen
Susanne R
SR
DSI Danish Institute for Health Services Research, Copenhagen, Denmark. srr@dsi.dk
Thomsen
Janus L
JL
Kilsmark
Jannie
J
Hvenegaard
Anne
A
Engberg
Marianne
M
Lauritzen
Torsten
T
Søgaard
Jes
J
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003718:Denmark / Q000453:epidemiology; D005194:Family Practice / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D010808:Physical Examination / Q000191:economics; D011314:Preventive Health Services / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*; D011795:Surveys and Questionnaires