The Hospital of the Faculty of Medical Sciences of the State University of Campinas is implementing an Integrated Health Care Programme, whose objectives are early detection of risk factors of several diseases and the evaluation of the patient's reproductive health at the moment of the first visit to the Hospital. The initial results of this program encouraged us to try to apply it all to our own clientele. The present lack of material resources and qualified manpower leads us to concentrate all our attention on the patient's immediate complaints. This situation indicated to us that the only way to implement the program should be by means of a computerized questionnaire able to detect diseases and risk factors early. This paper presents the preliminary results of the application of computerized questionnaires to evaluate health risks. The authors conclude: The application of a computerized questionnaire met with very favorable reception by the clientele; In some segments of the population, the questionnaire can be answered by the patients in direct interaction with the computer; Programmes which evaluate risk factors need to be carefully revised before being put to use; The system operates on a relatively low cost basis, which could bring undeniable benefits to primary health care.
PIP: This paper reports the preliminary results of the experimental use of a computerized questionnaire aimed at assessing health risks in women attending an integrated health care program. The questionnaire, which includes over 140 items, seeks to calculate reproductive risk as well as the risk of cancers of the cervix, breast, endometrium, ovary, stomach, and lung. It has been tested, either on a self-administered basis or with the aid of nursing personnel, on 500 patients at a hospital clinic. It took subjects 10-34 minutes to complete the questionnaire, with a median time of 18 minutes. 90% of respondents reported that they enjoyed answering the questions and had no difficulties understanding the text. When questionnaire results were compared with the results of clinical evaluations carried out by family planning clinic staff, it was found that 346 patients were using some type of contraceptive method that had not been revealed to clinic personnel; moreover, according to the questionnaire, 27% of the women who were using oral contraceptives had clinical conditions that contraindicated use of this method. These women showed overwhelming acceptance of the computer's recommendation that pill use be discontinued on the basis of health hazards. This program can be processed in small, cost-effective national microcomputers, facilitating its gradual installation in the primary health care network. It could become a useful tool in the reference and counterreference process between the primary health care system and centers of secondary and tertiary health care.