英国预防性健康检查的利用：来自 1992 年至 2008 年个体水平重复横断面数据的研究结果。
Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008.
机构信息
Department of Health Sciences, University of Leicester, Leicester, UK.
出版信息
BMJ Open. 2013 Dec 23;3(12):e003387. doi: 10.1136/bmjopen-2013-003387.
OBJECTIVES
To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK.
DESIGN
Individual-level analysis of repeated cross-sectional surveys with balanced panel data.
SETTING
The UK.
PARTICIPANTS
Individuals taking part in the British Household Panel Survey (BHPS), 1992-2008.
OUTCOME MEASURE
Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests.
METHODS
Dynamic panel data models (random effects panel probit with initial conditions).
RESULTS
Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening.
CONCLUSIONS
Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention.
TRIAL REGISTRATION
This observational study was not registered.
目的
分析和比较英国国民健康服务（NHS）健康检查不同项目的筛查参与率的决定因素。
设计
具有平衡面板数据的重复横断面调查的个体水平分析。
设置
英国。
参与者
参加英国家庭面板调查（BHPS）的个体，1992-2008 年。
结果测量
NHS 健康检查的参与率，包括宫颈癌筛查、乳腺癌筛查、血压检查、胆固醇检查、牙科筛查和视力检查。
方法
动态面板数据模型（带有初始条件的随机效应面板概率）。
结果
在 1 年前进行过健康检查，并且之前按照推荐的时间表进行过健康检查，与更高的健康检查参与率相关。看过全科医生（GP）的个体在 6 项健康检查中有 5 项的参与率显著更高。在推荐的乳腺癌和宫颈癌筛查年龄组中，参与率最高。对于所有健康检查，年龄与非直线关系相关。自评健康状况较差与血压检查和胆固醇检查的参与率增加相关；吸烟与 4 项健康检查的参与率降低相关。社会经济变量对不同的健康检查的影响不同。种族对任何健康检查都没有显著影响。常住家庭收入仅对视力检查和牙科筛查有影响。
结论
进行健康检查的常见决定因素是年龄、筛查史和看全科医生。为了提高参与率，政策干预措施应考虑全科医生在促进筛查检查和保持高水平参与率方面的核心作用。对于牙科筛查和视力检查，可能存在预防性医疗的经济障碍，这可能是政策干预的目标。
试验注册
本观察性研究未进行注册。
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