Primary Care Health Consultations Can Be Cost-effective And May Help Reduce Cardiovascular Risk, Say Doctors

The findings are the result of a five-year randomized trial: the Ebeltoft Health Promotion Project (EHPP), conducted by the Department of General Practice, Institute of Public Health, University of Aarhus, Denmark.

More than two thousand 30-49 year olds, based in Ebeltoft, Denmark, were invited to take part in the trial, of which 85% participated. The general practitioners invited the population to take part in a random allocation to one of three groups:

• A control group answering questionnaire.
• An intervention group having questionnaires, a broad health test with written advice, followed by a normal 10-15 minute consultation on deman.
• An intervention group as the former group, but with a planned 45 minute patient-centred consultation.

A key finding of the five year follow up was that patients participating in health tests and consultations demonstrated lower risk of heart and cardiovascular diseases: 19% in the control group had elevated risk factors compared to 10% in the two intervention groups.

The impact of testing was also found to be cost effective. The overall number of contacts to the health care system was not increased, and as such significantly better life expectancy was found without extra direct and total costs. Participants also reported an overall positive perception from having health tests and consultations.

The results demonstrate that the current scepticism towards screening and health testing among certain professional groups internationally is not supported.

“There has been a lot of doubt within the international community that there are health outcomes of health tests and patient centred consultations within primary care,” said lead author Dr Torsten Lauritzen. “In Denmark general practitioners are gate keepers to the entire health system. Almost all Danes are ascribed to specific general practitioners. Such findings suggest that clinicians and policy makers should now consider implementing health tests and consultations more widely.”