Therapeutic Value of the Periodic Health Examination

Therapeutic Value of the Periodic Health Examination
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Publisher:
Total Pages:
Release: 1965
Genre:
ISBN:

The Oak Ridge National Laboratory has been conducting periodic health examinations on all of its employees for over 10 years. The original purpose of this program was the early detection of disease to be followed by referral or appropriate counseling. Because of the relatively young age of this group, we expected that this service would be of greatest benefit to only the small percentage who had significant findings. However, over this 10 year period we have been increasingly impressed that those who had no significant findings have expressed almost as much enthusiasm and gratitude as those in whom we found early but potentially serious disease. This response caused us to look more critically at the reasons for this favorable reaction. As a result, we have become convinced that these examinations have an important therapeutic value to the healthy, as well as the sick, and that this fact should be considered in their justification. A health examination can quite properly be considered therapeutic, even though no disease is found or treated, providing it "serves" or meets some of the needs of the person being examined. After all, the literal definition of the word therapeutic is service, since it is derived from the Greek word therapeutikos, which means an attendant or servant.

Value of the Periodic Health Evaluation

Value of the Periodic Health Evaluation
Author: Department of Health & Human Services
Publisher: CreateSpace
Total Pages: 352
Release: 2014-05-28
Genre: Medical
ISBN: 9781499706659

The periodic health evaluation (PHE) consists of one or more visits with a health care provider to assess patients' overall health and risk factors for preventable disease, and it is distinguished from the annual physical exam by its incorporation of tailored clinical preventive services and laboratory testing as part of health risk assessment. By promoting prevention, management of chronic conditions, and enhancing the patient-provider relationship, the PHE may improve patient outcomes and the public's health. However, it could also induce unnecessary costs and patient harms by promoting the use of non-recommended services. Early studies of the PHE, performed before the adoption of current preventive services guidelines, were costly and demonstrated minimal improvement in clinical outcomes, leading to concern regarding the PHE's value and to the promotion of episodic, targeted delivery of preventive services in the context of ongoing clinical care. More recent clinical trials have reported scattered benefits of the PHE. Thus, despite its continued practice, the value of PHE in improving health and healthcare costs has been largely unclear. Private and public health insurance coverage for preventive services in the U.S. has gradually increased over time. However, increases are typically for one recommended service at a time, rather than a comprehensive set of preventive services. Recent legislation will provide coverage for a “Welcome to Medicare Visit” for new enrollees, incorporating a range of diagnostic and screening tests. Lack of clear evidence to support or refute its use, and recent legislation to cover preventive services on a wide scale provide the basis for this systematic review of the evidence to elucidate the value of the PHE.