Cholesterinbestimmung beim „Check ab 35”: Hat die Untersuchung Konsequenzen?

[The Bremen periodic health exam - feasibility of a new concept]

BACKGROUND

All members of the Statutory Health Insurance are entitled to receive preventive health examinations. The current concept, however, does not take individual risk factors into account systematically. To improve this, the "Bremen Health Examination" was developed. The central component is a screening questionnaire to be completed by the patient, which is stratified by age, i.e., 35 to 69 years and ≥ 70 years. The feasibility and acceptance of this concept have been assessed.

METHODS

In a prospective observational study, a selected sample of general practitioners (GPs) was asked to implement the questionnaires during all preventive health examinations within a four-week period. The GPs subsequently answered content-related questions as well as Likert-scaled questions on the relevance of the issues addressed, and the feasibility of the new concept.

RESULTS

17 out of 20 GPs approached for the study included a total of 171 patients. On average, the patients in the two groups were 52 and 75 years of age, respectively, and answered 4.4 prompting questions positively. Age and gender had no significant effect on the frequency of "positively" answered questions. Implementing the questionnaire extended the duration of the health examination, however, GPs overall rated the time required for discussing newly assessed problems as adequate (four-level Likert scale, 1=yes; 4=no; Ø 1.59; SD 0.77).

CONCLUSION

The implementation of the Bremen Health Examination appears to be feasible from the GP perspective.

[Check up 35: what benefits do general practitioners in Brandenburg see?]

INTRODUCTION

The so-called "Check up 35" is a structured preventive examination to be conducted by primary care providers. Recent interviews have shown that expectations with regard to this examination vary among physicians; some of them expressed doubt that the consultation is useful at all. The aim of this study was to representatively examine Brandenburg's family physicians' attitudes towards this "Check up".

METHODS

50% of the family physicians listed in the data base of the Association of SHI Physicians were randomly selected to receive a mail questionnaire (n=748). Participation in the study was voluntary, the questionnaires were evaluated anonymously. The physicians were asked about both content and assumed benefit of consultations.

RESULTS

The questionnaire was answered by 37% of the physicians (n=274). In 2008, 40 "Check ups" were conducted every three months. 96% of the physicians amended the standard programme with additional preventive examinations - most frequently serum creatinine measurements. In most of the respectively rated categories, they appreciate the usefulness of the examination. In contrast, they take a rather sceptical attitude towards the en bloc standard programme.

DISCUSSION

The study shows that many family physicians are very critical of the "Check up 35"; in particular, this applies to the range of scheduled examinations. There are considerable variations in the individual shaping of the consultation process among the physicians. They use the "Check up" as a tool for individual prevention instead of limiting it to the reduced standardised screening as intended.