Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, ACT 2601, Australia.
J Public Health (Oxf). 2013 Mar;35(1):92-8. doi: 10.1093/pubmed/fds088. Epub 2012 Oct 26.
As part of national policy to manage the increasing burden of chronic diseases, the Department of Health in England has launched the NHS Health Checks programme, which aims to reduce the burden of the major vascular diseases on the health service.
A cross-sectional review of response, attendance and treatment uptake over the first year of the programme in Stoke on Trent was carried out. Patients aged between 32 and 74 years and estimated to be at ≥20% risk of developing cardiovascular disease were identified from electronic medical records. Multi-level regression modelling was used to evaluate the influence of individual- and practice-level factors on health check outcomes.
Overall 63.3% of patients responded, 43.7% attended and 29.8% took up a treatment following their health check invitation. The response was higher for older age and more affluent areas; attendance and treatment uptake were higher for males and older age. Variance between practices was significant (P < 0.001) for response (13.4%), attendance (12.7%) and uptake (23%).
The attendance rate of 43.7% following invitation to a health check was considerably lower than the benchmark of 75%. The lack of public interest and the prevalence of significant comorbidity are challenges to this national policy innovation.
作为管理日益加重的慢性病负担的国家政策的一部分,英格兰卫生部推出了国民保健制度健康检查计划,旨在减少主要血管疾病对医疗服务的负担。
对特伦特河畔斯托克开展该计划的第一年的响应、参与和治疗情况进行了横断面回顾。从电子病历中确定了年龄在 32 至 74 岁之间、估计有 20%以上心血管疾病发展风险的患者。采用多水平回归模型评估了个体和实践水平因素对健康检查结果的影响。
总体而言,63.3%的患者做出了回应,43.7%的患者参加了健康检查,29.8%的患者在接到健康检查邀请后接受了治疗。年龄较大和较富裕地区的回应率较高;男性和年龄较大的患者的参与率和治疗率较高。实践之间的差异在回应(13.4%)、参与(12.7%)和治疗率(23%)方面具有统计学意义(P < 0.001)。
在接到健康检查邀请后,实际参与率为 43.7%,远低于 75%的基准。公众对此缺乏兴趣和普遍存在严重合并症,这是对这一国家政策创新的挑战。