Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, and RAND Europe, Cambridge.
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, and RAND Europe, Cambridge.
Br J Gen Pract. 2018 Jul;68(672):e449-e459. doi: 10.3399/bjgp18X697649. Epub 2018 Jun 18.
Since 2009, all eligible persons in England have been entitled to an NHS Health Check. Uncertainty remains about who attends, and the health-related impacts.
To review quantitative evidence on coverage (the proportion of eligible individuals who attend), uptake (proportion of invitees who attend), and impact of NHS Health Checks.
A systematic review and quantitative data synthesis. Included were studies or data reporting coverage or uptake and studies reporting any health-related impact that used an appropriate comparison group or before- and-after study design.
Eleven databases and additional internet sources were searched to November 2016.
Twenty-six observational studies and one additional dataset were included. Since 2013, 45.6% of eligible individuals have received a health check. Coverage is higher among older people, those with a family history of coronary heart disease, those living in the most deprived areas, and some ethnic minority groups. Just under half (48.2%) of those invited have taken up the invitation. Data on uptake and impact (especially regarding health-related behaviours) are limited. Uptake is higher in older people and females, but lower in those living in the most deprived areas. Attendance is associated with small increases in disease detection, decreases in modelled cardiovascular disease risk, and increased statin and antihypertensive prescribing.
Published attendance, uptake, and prescribing rates are all lower than originally anticipated, and data on impact are limited, with very few studies reporting the effect of attendance on health-related behaviours. High-quality studies comparing matched attendees and non-attendees and health economic analyses are required.
自 2009 年以来，英格兰所有符合条件的人都有权接受国民保健制度健康检查。谁会参加，以及健康相关的影响仍存在不确定性。
综述 NHS 健康检查的覆盖率（合格人群中参加者的比例）、参与率（受邀者中参加者的比例）和健康相关影响的定量证据。
系统评价和定量数据综合。包括报告覆盖率或参与率的研究或数据，以及使用适当对照或前后研究设计报告任何健康相关影响的研究。
搜索了 11 个数据库和其他互联网资源，截至 2016 年 11 月。
纳入了 26 项观察性研究和一个额外的数据集。自 2013 年以来，45.6%的合格者接受了健康检查。老年人、有冠心病家族史的人、生活在最贫困地区的人以及一些少数族裔群体的覆盖率较高。近一半（48.2%）的受邀者接受了邀请。关于参与率和影响（尤其是与健康相关行为）的数据有限。老年人和女性的参与率较高，但生活在最贫困地区的人较低。参加者与疾病检出率略有增加、心血管疾病风险模型降低以及他汀类药物和抗高血压药物处方增加有关。
与最初预期相比，发表的参与率、参与率和处方率都较低，并且关于影响的数据有限，很少有研究报告参加对健康相关行为的影响。需要进行比较匹配的参与者和非参与者以及健康经济学分析的高质量研究。
