[Utilization of medical services]

In order to measure all effects of a community intervention program such as the NRP 1A "Primary prevention of cardiovascular disease in Switzerland", use of health services should be taken into account, too. Data from the cross-sectional baseline assessment in the Swiss-German town of Aarau and the Swiss-French town of Nyon show that women had significantly more physician office visits than men (42.9 and 33.9% within three months). Women also had more hospital admissions (21.7 and 13.4% over a period of two years). There were no differences regarding sick-days (11.7 and 10.2% within three months). There was a significant difference between the two parts of the country: there were more hospital admissions in the Swiss-French town. Males indicated that a considerable fraction of the reasons for the last physician visit was a preventive health control, without the presence of any signs or symptoms. The differences found in this study are in partial agreement with several large data systems of Swiss health insurance carriers. Persons participating only after intensive recruitment use health services more than the group of those volunteering. The level of use correlates inversely with the social class and, among women only, with cigarette smoking. An intervention program has to make a special effort to include those who do not volunteer right away.