Observance of advice on prevention and healthcare among vulnerable people: the Health Insurance health examination centres experiment

Aims: Health Insurance health examination centres should help encourage incorporation of socially vulnerable people into the healthcare system. The aim of this enquiry was to document results obtained by administration of health examinations to such people. Methods: A sample group of socially vulnerable people was monitored over a period of six months to a year after health examinations were carried out at health examination centres. Results of examinations were documented either by the treating physician (by letter)or by the person him or herself (by letter or by telephone interview). Reasons for follow-up were suspected hypertension or diabetes, uncontrolled obesity, need of buccodental care, lack of anti-tetanus vaccination, and absence of mammographic screening. Results: In this group, 389 socially vulnerable subjects were monitored at 11 health examination centres. After six months, 81.5% of them had consulted a physician, 55.6% had updated their anti-tetanus vaccinations and 44.6% had sought dental treatment. A year after the examination, 82% of the subjects monitored for hypertension,diabetes or obesity stated that they had undertaken treatment in line with the recommendations of their physicians. Conclusion: The study showed that the health examinations carried out were beneficial for most of those who took part in the enquiry, in terms of screening for and treatment of chronic pathologies, vaccination updating and dental care. The health examination system has proven to be an effective means of helping reduce health inequalities in the context of healthcare protocols. Prat Organ Soins. 2011;42(2):79-87