Evaluation of a practice-based programme of health checks: financial cost and success at risk detection

With the help and supervision of a facilitator, a scheme of nurse-run health checks was established in 1983 in a suburban group practice of approximately 12,000 patients. The practice receptionists recruited patients opportunistically when they presented to consult a doctor. After two and a half years, 1382 patients had been screened for cardiovascular risk factors; this was 94.0% of those invited to attend and 24.9% of the target population of patients aged 25-64 years. Recording of risk factors increased greatly between 1983 and 1986, although uptake of immunizations was low. Sixty five previously undiagnosed hypertensives were identified, as were 11 new diabetics. This was achieved with two sessions per week; thus to succeed in screening the whole population within five years, four weekly sessions would have been necessary. When the cost of equipment and staff salaries were offset against 70% reimbursement of salaries and item of service fees the net financial cost to practice from 1983-86 was approximately 1.73 pounds per patient, or 477.00 pounds per clinic session per year.