School of Health and Related Sciences, University of Sheffield, Sheffield, UK.
Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan Campus, Australia.
Sci Rep. 2017 Oct 16;7(1):13235. doi: 10.1038/s41598-017-12904-4.
This study analysed the determinants of screening uptake for blood pressure and cholesterol level checks. Furthermore, it investigated the presence of possible spillover effects from one type of cardiovascular screening to another type of cardiovascular screening. A dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) was adopted for the estimation. The outcome variables were the participation in blood pressure and cholesterol level checks by individuals in a given year. The balanced panel sample of 21,138 observations was constructed from 1,626 individuals from the British Household Panel Survey (BHPS) between 1996 and 2008. The analysis showed the significance of past screening behaviour for both cardiovascular screening examinations. For both cardiovascular screening examinations state dependence exist. The study also shows a significant spillover effect of the cholesterol level check on the blood pressure check and vice versa. Also a poorer health status led to a higher uptake for both types of screening examinations. Changes in recommendations have to consider the fact that taking part in one type of cardiovascular screening examination can influence the decision to take part in the other type of cardiovascular screening examination.
本研究分析了血压和胆固醇水平检查筛查参与的决定因素。此外,还调查了一种心血管筛查对另一种心血管筛查是否存在可能的溢出效应。采用具有初始条件的动态随机效应双变量面板概率模型(Wooldridge 型估计量)进行估计。因变量为给定年份个体参与血压和胆固醇水平检查的情况。该平衡面板样本由 1996 年至 2008 年间来自英国家庭面板调查(BHPS)的 1626 个人组成,共有 21138 个观测值。分析表明,过去的筛查行为对两种心血管筛查检查都具有重要意义。两种心血管筛查检查都存在状态依存性。该研究还表明,胆固醇水平检查对血压检查有显著的溢出效应,反之亦然。较差的健康状况也会导致两种筛查检查的参与率更高。建议的改变必须考虑到这样一个事实,即参与一种心血管筛查检查可能会影响参与另一种心血管筛查检查的决定。