Periodic health examination by Austrian general practitioners.

In European countries professional opinions differ about the usefulness of periodic health examination (PHE). Austria and Germany are the only one with a standardized PHE in the basic social insurance package. New insights in the role of GPs in monitoring population health and the role of PHE in enhancing population health have been developed since the introduction in 1970. Description: The umbrella organization of Austrian Social Insurance Carriers commissioned a project to modernize the system of PHE and to bring it in line with the principles of evidence-based medicine. The project focussed on adapting the original forms of the PHE for a number of priority domains. The aim was to define a small number of self-administered questions that could be used to define risk profiles of patient groups. Risk profiles should be connected to health education tools, which can be applied, in general practice. Feasibility in a general practice context is therefore important, apart from being in line with international evidence and experience. Lessons: Annually, approximately 800 000 people (out of six million eligible) use PHE, accumulating to large numbers over time. The PHE is an income component of GPs (70 per PHE) and therefore of interest to them. The turnout shows a demand for PHE of the insured population. There is lack of evidence both on the utility of PHE in general and on the design of the specific documentation. Computerization is necessary to produce individual risk profiles from patient information forms and to produce public health information on the basis of PHE. Conclusions: Currently, the observed public health value is low because of self-selection of examined patients and because the information from PHE is not aggregated nor linked to research in the primary health care—public health interface. Although PHE could be a link between health promotion and health care, this opportunity is presently not fully exploited. (aut.ref.)