Zhongguo quanke yixue (Apr 2024)
The Utilization of Health Checkup Services among People Aged 45 and above in China: a National Cross-sectional Survey Based on CHARLS 2018
Abstract
Background Research on the utilization of outpatient and inpatient health services and its influencing factors has been well established, but there are few studies on the utilization of preventive medical services such as health checkup by residents in China. Objective To investigate the utilization of health checkup in Chinese residents aged 45 years and above and analyze its influencing factors. Methods Using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), the population aged≥45 years was selected to calculate the rate of participation in health checkup and the number of health checkup items from 2015 to 2018. Zero-inflation negative binomial regression was used to analyze the influencing factors of the number of health checkup items attended by residents. Results A total of 17 203 samples were included in this study, with an average age of (62.4±10.0), and the participation rate of 47.73% (8 21/17 203). The top three in participation rate in health checkup were Xinjiang Uygur Autonomous Region (96.47%), Shanghai (83.67%) and Beijing (82.05%), while the bottom three were Liaoning Province (35.41%), Qinghai Province (36.55%) and Fujian Province (36.94%). Among the 8 211 people who had participated in health checkup, the average age was (64.1±9.9) years old, and the median number of health checkup items per capita was 9 (5, 12). The top three in the number of health checkup items were Beijing Municipality (14 items), Shanghai Municipality (14 items) city and Xinjiang Uygur Autonomous Region (13 items), and the bottom three were Gansu Province (7 items), Anhui Province (7 items) and Liaoning Province (7.5 items). Non-parametric test showed that the number of health checkup items in urban residents was significantly higher than that in rural areas (10 items vs. 8 items), the eastern region was significantly higher than the central (10 items vs. 8 items), western (10 items vs. 8 items) and northeast (10 items vs. 8 items) region, the western region was significantly higher than the central region (9 items vs. 8 items) (P<0.001). The Zinb model showed that economic region (central, western, and northeastern), type of residence (urban area), gender (female), age (60 years and above), education level (junior high school and above), health status (comorbidity), and type of basic health insurance (employee health insurance) were the factors influencing the number of health checkup items attended by residents (P<0.001). Subgroup analysis according to urban and rural areas showed that economic region (central, western, and northeastern), age (60 and above), and education level (junior high school and above) were the common influencing factors on the number of health checkup items attended by urban and rural residents (P<0.05). In addition, for residents of urban areas, being married was an influential factor in the number of health checkup items attended (P<0.001) ; for residents of rural areas, being male, comorbidity, and employee health insurance were the factors influencing the number of health checkup items attended (P<0.001) . Conclusion The people aged 45 years and above in China have a low utilization rate of health checkup services, health check-up services are more available in urban and eastern areas. Age and education level are the influencing factors of utilization of health checkup services. Marital status is the influencing factor of utilization of health checkup services in urban, gender, health status and type of basic medical insurance are the influencing factors of the utilization of health checkup services in rural. In the future, the utilization of health checkup services should be further improved, different policies and measures should be formulated according to urban and rural areas, as well as geographical regions.
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