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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Cindy A Kermott, Carol S Kuhle, Stephanie S Faubion, Ruth E Johnson, Donald D Hensrud, Mohammad Hassan Murad
Wichtige Hinweise

Competing interests

The authors declare that they have no financial competing interests. As authors and physicians in clinical practice, our only competing interest is that we provide medical care in the PHE model.

Authors’ contributions

CAK, submitting author, devised the initial research proposal concept and design, further directed the data abstraction process, data analysis, interpretation, and guided the team of physician researchers for this article covering all sections. CSK, drafted our Results and Table section. SSF and REJ drafted the Discussion and Conclusion sections. DDH drafted the Introduction and provided the impetus guiding this publication. MHM provided the mentorship for our research team. All authors read and approved the final manuscript.

Abstract

Background

The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear.

Methods

We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention).

Results

The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients’ complaints (71%) and would not have been identified by screening guidelines (51%). Men (odds ratio 2.67; 95% CI, 1.76, 4.03) and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19) were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort.

Conclusion

The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.
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