J Korean Acad Community Health Nurs.  2019 Dec;30(4):508-517. 10.12799/jkachn.2019.30.4.508.

Factors Influencing Participation in National Health Screening Program among Korean Older Adults by Cognitive Function Level

• Han SY
• Ko Y

• KMID: 2467651
• DOI: http://doi.org/10.12799/jkachn.2019.30.4.508

Abstract

PURPOSE
The aim of this study was to identify the participation rate of the National Health Screening Program (NHSP) and its influencing factors by cognitive function level in Korean older adults.
METHODS
This study was a secondary analysis using data from the survey of the Korean Longitudinal Study of Aging in 2016. The data were analyzed using χ² test and multiple logistic regression.
RESULTS
The participation rates of the NHSP in the mild cognitive impairment group (79.6%) and the suspected dementia group (58.0%) were lower than the normal cognitive function group (88.1%). The factors influencing NHSP varied by cognitive function level. Especially, in the suspected dementia group, higher participation rates of the NHSP were associated with living in rural areas, enrollment in private health insurance, no depressive symptoms, participation in social activities, and no living with children. Depression and participation in social activities influenced participation in NHSP in all groups.
CONCLUSION
This study suggests that interventions differentiated by cognitive function level are important for increasing the participation in the health screening.

Keyword

Aged; Mass screening; Cognition

Reference

1. OhYH. Health status and policy for the elderly [Internet]. Sejong: Korea Institute for Health and Social Affairs;2013. cited 2018 December 01. Available from: http://repository.kihasa.re.kr/handle/201002/10981.

2. Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O'Donnell M, Sullivan R, et al. The burden of disease in older people and implications for health policy and practice. The Lancet. 2015; 385:549–562. DOI: 10.1016/S0140-6736(14)61347-7.

3. Ministry of Health and Welfare. 2017 elderly survey [Internet]. Sejong: Ministry of Health and Welfare;2017. cited 2019 July 15. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_.

4. National Health Insurance Service. 2018 Health Insurance Statistics [Internet]. Wonju: National Health Insurance Service;2019. cited 2019 July 15. Available from: https://www.nhis.or.kr/bbs7/boards/B0074/29670?boardKey=29&boardName=B0074.

5. Schülein S, Taylor KJ, Schriefer D, Blettner M, Kluga SJ. Participation in preventive health check-ups among 19,351 women in Germany. Preventive Medicine Reports. 2017; 6:23–26. DOI: 10.1016/j.pmedr.2017.01.011.

6. Cook EJ, Sharp C, Randhawa G, Guppy A, Gangotra R, Cox J. Who uses NHS health checks Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks. International Journal for Equity in Health. 2016; 15:13. DOI: 10.1186/s12939-016-0303-2.

7. Yoon S, Jun DB, Park S. The effect of general health checks on healthcare utilization: Accounting for self-selection bias. Journal of Royal Statistical Society, series. 2019; 1:1–34. DOI: 10.1111/rssa.12482.

8. Dryden R, Williams B, McCowan C, Themessl-Huber M. What do we know about who does and does not attend general health checks Findings from a narrative scoping review. BMC Public Health. 2012; 12:723. DOI: 10.1186/1471-2458-12-723.

9. National Health Insurance Service. 2017 The National Health Screening Statistical Yearbook [Internet]. Wonju: National Health Insurance Service;2017. cited 2019 June 17. Available from: http://www.nhis.or.kr/menu/boardRetriveMenuSet.xx?menuId=F3328.

10. Kang SY, Lee JA, Kim YS. Knowledge and attitude of health care providers for Korean National Health Examination. Korean Journal of Health Promotion. 2017; 17(4):252–258. DOI: 10.15384/kjhp.2017.17.4.252.

11. Central Dementia Center. 2018. 2016 National Dementia Epidemiology Survey [Internet]. Seongnam: Central Dementia Center;2018. cited 2019 July 23. Available from: https://www.nid.or.kr/notification/data_view.aspx?board_seq=76.

12. Ritchie K, Ancelin ML, Beaino E, Portet F, Brickman AM, Dartigues JF, et al. Retrospective identification and characterization of mild cognitive impairment from a prospective population cohort. The American Journal of Geriatric Psychiatry. 2010; 18(8):692–700. DOI: 10.1097/jgp.0b013e3181df4897.

13. Lee YK, Sung MR, Lee DY. Comorbidity and health habits of Seoul city elders with dementia. Journal of Korean Academy of Nursing. 2011; 41(3):411–422. DOI: 10.4040/jkan.2011.41.3.411.

14. Yeo JY, Jeong HS. Determinants of health screening and its effects on health behaviors. Health Policy and Management. 2012; 22(1):49–64. DOI: 10.4332/KJHPA.2012.22.1.049.

15. Jung YK. Determinants of general health check-up among older adults in Korea. Crisisonomy. 2018; 14(1):135–148. DOI: 10.14251/crisisonomy.2018.14.1.135.

16. Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: An analysis of data from a prospective cohort study. The Lancet Public Health. 2018; 3(9):e438–e446. DOI: 10.1016/S2468-2667(18)30141-5.

17. Vozikaki M, Linardakis M, Philalithis A. Preventive health services utilization in relation to social isolation in older adults. Journal of Public Health. 2017; 25(5):545–556. DOI: 10.1007/s10389-017-0815-2.

18. Park KY, An HG. Factors influencing the health examination in middle-aged men in Korea: Using data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-1), 2013. Journal of the Korean Data Analysis Society. 2016; 18(2):1035–1049.

19. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine. 1999; 159(15):1701–1704. DOI: 10.1001/archinte.159.15.1701.

20. Chung SD, Koo MJ. Factors influencing depression: A comparison among babyboomers, the pre-elderly, and the elderly. Jounal of Welfare for the Aged. 2011; 52:305–324.

21. Korea Employment Information Service. User's guide of 2019 Korean Longitudinal Study of Ageing (KLoSA). Eumseong: Korea Employment Information Service;2019. cited 2019 April 2. Available from: https://survey.keis.or.kr/klosa/klosaguide/List.jsp.

22. Ministry of Health and Welfare. The 4th Health plan 2020 ('16~'20). Sejong: Ministry of Health and Welfare;2016. cited 2019 June 11. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=0319&CONT_SEQ=330479&page=1.

23. Gidlow C, Ellis N, Randall J, Cowap L, Smith G, Iqbal Z, et al. Method of invitation and geographical proximity as predictors of NHS Health Check uptake. Journal of Public Health. 2015; 37(2):195–201. DOI: 10.1093/pubmed/fdu092.

24. Oh S, Ko Y. Activities of daily living, depression, and self-rated health and related factors in Korean elderly: Focused on socioeconomic status and family support. Journal of Korean Academy of Community Health Nursing. 2015; 26(2):140–149. DOI: 10.12799/jkachn.2015.26.2.140.

25. Sommers BD, Blendon RJ, Orav J, Epstein AM. Changes in utilization and health among low-income adults after medicaid expansion or expanded private insurance. JAMA Internal Medicine. 2016; 176(10):1501–1509. DOI: 10.1001/jamainternmed.2016.4419.

26. Lee YC, Im BH, Park YH. The determinants and comparison of health behavior and health service by private medical insurance on national health-nutrition survey. Journal of the Korea Contents Association. 2010; 10(12):190–204.

27. Schmitz H, Wubker A. What determines influenza vaccination take up of elderly Europeans. Health Economics. 2011; 20(11):1281–1297. DOI: 10.1002/hec.1672.

28. Kim JG. The impact of family type on health behavior of elderly people. Korean Journal of Gerontological Social Welfare. 2011; 51:35–55.

29. Shin SH, Jang KS, Choi O. Study of the successful aging of the elderly women in rural area. Journal of Health Informatics and Statistics. 2019; 44(2):198–205. DOI: 10.21032/jhis.2019.44.2.198.

30. Park M, Sung MR, Kim SK, Lee DY. Comparison of demographic characteristics, comorbidity, and health habits of older adults with mild cognitive impairment and older adults with normal cognitive function. Journal of Korean Academy of Nursing. 2014; 44(4):351–360. DOI: 10.4040/jkan.2014.44.4.351.