Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand.
Health Solution Research Unit, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand.
Front Public Health. 2024 May 10;12:1390125. doi: 10.3389/fpubh.2024.1390125. eCollection 2024.
Thailand has provided free annual health checkups (AHC) since universal health coverage began in 2002. However, evidence regarding the equitable use of AHC is scarce. Thus, this study explored factors associated with the use of AHC in Thailand.
A cross-sectional study was conducted using data from the national 2015 Health and Welfare Survey. Respondents aged 15 years or above ( = 57,343) were selected as the study sample. Descriptive statistical analysis and multivariable binary logistic regression were conducted to examine the association between the use of AHC and factors selected on the basis on Andersen's Behavioral Model of Access to Medical Care.
Among the study sample, approximately 4.9% ( = 2,815) had used AHC during the past year. Regarding predisposing factors, the use of AHC was positively related to age (e.g., over 61 vs. 15-30: AOR = 2.90 [95% CI = 2.40-3.52], < 0.001) and female sex (AOR = 1.23 [95% CI = 1.12-1.35] < 0.001). For enabling factors, the AHC use was positively associated with income (e.g., Q4 vs. Q1: AOR = 1.98 [95% CI = 1.75-2.25], < 0.001), education (e.g., high vs. low: AOR = 3.11 [95% CI = 2.75-3.51], < 0.001), being married (e.g., vs. single: AOR = 1.27 [95% CI = 1.11-1.46], < 0.001), and urban residency (AOR = 1.12 [95% CI = 1.04-1.22], = 0.006). For need-for-care factors, the AHC use was positively related to chronic disease (AOR = 1.26 [95% CI = 1.15-1.38], < 0.001), non-smoking (e.g., vs. daily: AOR = 1.18 [95% CI = 1.03-1.36], = 0.015), non-drinking (e.g., vs. 3-4 times per week: AOR = 1.26 [95% CI = 1.04-1.53], = 0.016), and vegetable consumption (e.g., over 5 ladles vs. below 1 ladle: AOR = 1.86 [95% CI = 1.50-2.31], < 0.001).
The results indicate that health awareness could play a significant role in the use of AHC. Individuals with high socioeconomic status (e.g., high-income people) and those with low-risk health behaviors (e.g., non-smokers) generally have a high interest in health and well-being. This may have been the primary reason for the high use of AHC among these groups. Thus, the government should continue to promote the public's health awareness through various public campaigns and education programs to increase the use of AHC.
自 2002 年泰国开始实施全民医保以来，一直提供免费的年度健康检查（AHC）。然而，关于 AHC 公平使用的证据却很少。因此，本研究旨在探讨与泰国 AHC 使用相关的因素。
本研究采用 2015 年全国健康与福利调查的数据进行了一项横断面研究。选择年龄在 15 岁及以上的受访者（ = 57343）作为研究样本。采用描述性统计分析和多变量二项逻辑回归分析，检验了使用 AHC 与基于 Andersen 医疗保健获取行为模型选择的因素之间的关系。
在研究样本中，大约有 4.9%（ = 2815）的人在过去一年中使用过 AHC。在倾向因素方面，使用 AHC 与年龄呈正相关（例如，61 岁以上 vs. 15-30 岁：OR = 2.90 [95%CI = 2.40-3.52]， < 0.001）和女性性别（OR = 1.23 [95%CI = 1.12-1.35]， < 0.001）。在促进因素方面，AHC 使用与收入呈正相关（例如，Q4 与 Q1：OR = 1.98 [95%CI = 1.75-2.25]， < 0.001）、教育程度（例如，高 vs. 低：OR = 3.11 [95%CI = 2.75-3.51]， < 0.001）、已婚（例如，与单身：OR = 1.27 [95%CI = 1.11-1.46]， < 0.001）和城市居住（OR = 1.12 [95%CI = 1.04-1.22]， = 0.006）。在需要护理的因素方面，AHC 使用与慢性病呈正相关（OR = 1.26 [95%CI = 1.15-1.38]， < 0.001）、非吸烟（例如，与每日吸烟：OR = 1.18 [95%CI = 1.03-1.36]， = 0.015）、非饮酒（例如，与每周饮酒 3-4 次：OR = 1.26 [95%CI = 1.04-1.53]， = 0.016）和蔬菜摄入量（例如，超过 5 勺与低于 1 勺：OR = 1.86 [95%CI = 1.50-2.31]， < 0.001）呈正相关。
研究结果表明，健康意识可能在 AHC 使用中发挥重要作用。具有高社会经济地位（如高收入人群）和低健康风险行为（如不吸烟者）的个体通常对健康和福祉感兴趣。这可能是这些群体高使用率 AHC 的主要原因。因此，政府应继续通过各种公共宣传和教育项目来提高公众的健康意识，以增加 AHC 的使用。
