PubMed1993
Participants in a community secondary prevention action sponsored by the local government were compared with non-participants with respect to utilization of medical facilities for medical examinations. The study sample consisted of 1,013 males and 1,042 females aged 40 years or over, in a rural town in Kyoto prefecture, who were members of the National Health Insurance. Data from National Health Insurance records, such as date of consultation and type of medical examinations, were analyzed. The secondary prevention action sponsored by the town consisted of a multiphasic health check for circulatory or other chronic diseases, and screenings for tuberculosis and cancers of the stomach, lung, breast and cervix. Medical examinations included urine test, blood cell count, electrocardiography, laboratory tests for serum transaminases, serum glucose, and fecal occult blood, X-ray or endoscopy of the stomach, chest X-ray, mammography, and cervical cytology. Results of the study showed that those who attended the town sponsored secondary prevention action were more likely to utilize local medical facilities, and those who did not participate were likely to visit facilities outside the town. Medical facilities, both local and outside the town, had a larger proportion of examinations corresponding to health examinations or stomach cancer screening than the town office, however, the town office had a larger proportion of lung or cervical cancer screening. The health examination and stomach cancer screening in the town office, and in the medical facilities appeared to be redundant while lung and cervical cancer screening were complemented tests at medical facilities. When these examinations are targeted as modifying factors in the natural history of diseases, consideration should be given to both the records of secondary prevention actions as well as medical records of other medical facilities that may be utilized.