[Usefulness of physical examination at school]

To evaluate the utility of school health examinations performed at four years of age.

Evaluation of the results of school health examinations performed on 5,709 children are presented, with the follow up of selected problems found (overweight, growth failure, strabismus, reduced uncorrected visual acuity, hearing loss, psychomotor development and speech development impairment, hydrocele, cryptorchism, haematuria, dental caries and heart murmur).

4-year old kindergarten children assessed in the school health program in the city of Barcelona (Catalonia, Spain).

The examination identified 1,177 suspected defects in 960 children. Through a telephone interview with the families of 745 of these children, it was found that only 34.1% were previously unknown to families. The most frequently unknown problem was dental caries. Professional help was sought for 54.3% of the suspected defects. Only 10.5% of the suspected problems began any sort of treatment. The most frequently treated problems wer previously uncorrected refractive defects of the vision. Families report that 8.2% of the suspected problems improve.

These results suggest that the current health output of school health examinations in our city is modest, and that their cost-opportunity should be reviewed.