Using Risk-Assessment Sheet to Improve Effectiveness of Health Examination Service
Kraisorn Tohtubtiang MD,* Usa Tantibhaedhyangkul MD*
Affiliation : *Department of Family Medicine, Phramongkutklao Hospital, Bangkok 10400, Thailand
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.
Materials and Methods : Risk-assessment sheets were constructed based on recommendations in Guide to
Periodic Health Examination and Maintenance for Thai People . One hundr ed 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 hospital s computer before the
risk-assessment sheets were developed.
Results : Clients using the risk-assessment sheets group received recommended health examination signifi-
cantly 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.
Keywords : Risk-assessment sheet, Health examination, Effectiveness
