Using risk-assessment sheet to improve effectiveness of health examination service.

ABSTRACT

BACKGROUND: Several techniques to improve compliance of physicians toward health examination guidelines of many countries were studied. However the method to improve compliance of Thai physicians toward Thailand's guidelines has never been studied. OBJECTIVES: To determine the effectiveness of using risk-assessment sheets to improve the compliance of physicians toward Thailand's health examination service guideline. MATERIAL AND METHOD: Risk-assessment sheets were constructed based on recommendations in Guide to Periodic Health Examination and Maintenance for Thai People. One hundred and two adult clients who came for health examination service from January to March 2003 were asked to fill in risk-assessment sheets and compared them with 103 recorded health examination report from the hospitals computer before the risk-assessment sheets were developed. RESULTS: Clients using the risk-assessment sheets group received recommended health examination significantly more than those in the non-using group (p < 0.01). In the using group, rates of providing chest x-ray, tumor markers and average number of laboratory investigations were statistically significant lower (p < 0.01) and contrary to the rate of Pap test was statistically significant higher (p < 0.016) than the non-using group. The average expenditure of the using-group was 41.3% lower than non-using group. CONCLUSION: Using a risk-assessment sheet in health examination statistically and practically increased the compliance of physicians toward health examination guidelines and reduced unnecessary expenditure.