A Population-Based Nationwide Cross-Sectional Study on Preventive Health Services Utilization in Portugal—What Services (and Frequencies) Are Deemed Necessary by Patients?

Abstract

BackgroundMost of the strategies to induce a more rational use of preventive health services are oriented to the medical side of the doctor-patient relationship. However, the consultation model has changed, and patients now have a more important role in medical consultation. The aim of this study was to assess which healthcare services are deemed necessary, and with what frequency, by adults from the general Portuguese population.Methods Design: Population-based nationwide cross-sectional study Setting: Portuguese population Participants: One thousand Portuguese adults, surveyed by computer-assisted telephone interviewing and selected by a stratified cluster sampling design. Measurements: Proportions and population prevalence estimates were determined for each healthcare service, taking into account whether respondents considered them necessary, and with what frequency.ResultsRespondent ages ranged between 18 and 97 years, and 520 of 1000 (52%) respondents were women. Among Portuguese adults, 99.2% (95% confidence interval (CI): 98.5 to 99.6) believe that they should undergo general routine blood and urine tests, to be repeated every 12.0 months on average (95% CI: 11.4 to 12.6); 87.4% (95% CI: 85.3 to 89.3) of the respondents reported having actually performed these tests. Of the 15 services surveyed, 14 were considered periodically necessary by more than 60% of respondents. Among the respondents, 37.7% (95% CI: 34.5 to 41.1) reported using healthcare services by their own initiative.ConclusionsThe majority of Portuguese adults believe that they should utilize a great number of healthcare services, on a nearly annual basis; most actually follow this schedule. Our findings indicate a tendency towards the overuse of resources.Adequate patient-oriented strategies regarding the use of medical tests and preventive interventions—with appropriate information and discussion of risks and harms—are urgently needed, and crucial for achieving a more rational use of healthcare services and for preventing the consequences of over-testing.

Determinants of individuals' participation in integrated chronic disease screening in Singapore

“…Other studies have found that costs and insurance coverage heavily influence healthcare usage, including for preventive services, in systems where healthcare costs are borne by users,7 10–12 but are less important in countries with tax-based health systems that do not impose charges on end users 40 41. Singapore's health system operates on the principles of universal health insurance with copayment by end users, so cost could still be a factor especially for those at the lower end of the socioeconomic spectrum.…”

Requisição de Análises de “Rotina” em Medicina Geral e Familiar: Um Estudo Observacional Transversal Analítico Baseado na Prática em Portugal

“…13 Com este estudo verificou-se que mais de metade dos médicos ainda prescreve AR, o que não está de acordo com as recomendações atuais que defendem não existir benefício (mas sim um potencial aumento do risco de causar dano) para o doente na requisição de AR. 6 Impôs-se a necessidade de realizar um estudo qualitativo para apurar os motivos que levam à manutenção desta má prática nomeadamente explorar se existe uma perversão da relação médico--doente na qual o médico não tenha poder para fazer face a questões culturalmente instituídas.…”

“…5 Em Portugal a maioria dos adultos considera necessário a realização quase anual de um grande número de exames médicos e a maior parte indica que estes lhes são prescritos. 6 Na prática de Medicina Geral e Familiar (MGF), continua a não se verificar consistência entre médicos relativamente à avaliação complementar requerida para efetuar um controlo de "rotina".…”

Overuse of Medical Tests: A New Health Risk Factor?

“…Evidence shows a tendency to overuse preventive health services. 2,3 In Portugal, for example, a recent population-based cross-sectional study showed that the majority of Portuguese adults think they should undergo general routine blood and urine tests on an annual basis. Other, even less-recommended screening tests, such as lung X-rays, breast ultrasounds, abdominal ultrasounds, and gynaecological ultrasounds, are deemed necessary by a great proportion of the population.…”

“…Other, even less-recommended screening tests, such as lung X-rays, breast ultrasounds, abdominal ultrasounds, and gynaecological ultrasounds, are deemed necessary by a great proportion of the population. 3 In part, this pattern of behaviour may be justified by the culturally-rooted idea that routine general health checks are necessary. Obtaining general health checks is a practice that is not supported by evidence -it does not reduce morbidity or mortality, neither overall nor from cardiovascular or cancer-related illnesses, although they can increase the number of new diagnoses.…”