Kelleher Dan, Doherty Edel, O'Neill Ciaran
Health Economics and Policy Analysis Centre, National University of Ireland, Galway, Ireland.
Centre for Public Health, Queen's University Belfast, Ireland.
Prev Med Rep. 2021 Aug 3;24:101514. doi: 10.1016/j.pmedr.2021.101514. eCollection 2021 Dec.
Despite the economic and health benefits of preventive care being well established, the uptake of many cost-effective preventive services remains lower than desired in many cases, especially among specific sub-populations. The value an individual places on health can influence their uptake of preventive care. One way to capture the value an individual places on health and future health status is to examine their health preferences. This study used a novel use of EQ-5D-5L health preferences to determine if health preferences are associated with the uptake of a range of preventive care services, including a cancer screening, blood pressure check, cholesterol check, blood test and urine test. We collected EQ-5D-5L composite time trade-off data in 2018/2019 on 242 respondents residing in Ireland. We estimated an initial tobit model to predict an individual's health preference to capture health preferences as a regressor. We then estimated a bivariate probit model to examine the uptake of each preventive service and GP use. Each model controlled for health preferences, education, sex, type of health coverage, self-reported health, employment status, age and marital status. Health preferences are a significant determinant of all five preventive services while controlling for other covariates. The results shows that the higher an individual values good health, the more likely they are to avail of preventive care. Health preferences can be noted as a potential determinant of preventive care use that could guide policy responses seeking to increase demand-side factors for preventive care uptake.
尽管预防性保健在经济和健康方面的益处已得到充分证实,但在许多情况下,许多具有成本效益的预防性服务的采用率仍低于预期,尤其是在特定亚人群中。个人对健康的重视程度会影响他们对预防性保健的采用。衡量个人对健康和未来健康状况重视程度的一种方法是考察他们的健康偏好。本研究创新性地利用EQ-5D-5L健康偏好来确定健康偏好是否与一系列预防性保健服务的采用相关,这些服务包括癌症筛查、血压检查、胆固醇检查、血液检测和尿液检测。我们在2018/2019年收集了居住在爱尔兰的242名受访者的EQ-5D-5L综合时间权衡数据。我们估计了一个初始托比特模型,以预测个人的健康偏好,将健康偏好作为一个回归变量。然后,我们估计了一个双变量概率模型,以考察每项预防性服务的采用情况和全科医生的使用情况。每个模型都控制了健康偏好、教育程度、性别、健康保险类型、自我报告的健康状况、就业状况、年龄和婚姻状况。在控制其他协变量的情况下,健康偏好是所有五项预防性服务的一个重要决定因素。结果表明,个人对健康的重视程度越高,他们就越有可能利用预防性保健服务。健康偏好可被视为预防性保健使用的一个潜在决定因素,这可能会指导旨在增加预防性保健需求方因素的政策应对措施。