Abstract
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.
Highlights
Individuals can take part in different health screening examinations in the UK
The blood pressure can be checked by a GP or another healthcare professional, and it is recommended that adults aged over 20 are checked at least every 5 years and the recommendations for regular blood pressure are dependent on age, health status and existing diseases, health behaviour and lifestyle[7]
It is recommended to do this test every 1–2 years for all individuals who are overweight or obese and have high blood pressure or diabetes or who have been diagnosed with coronary heart disease, stroke, peripheral arterial disease or who have a family history of early cardiovascular disease or a close family member with a cholesterol-related condition, such as familial hypercholesterolemia
Summary
Individuals can take part in different health screening examinations in the UK. These screening examinations include blood pressure check, cholesterol level check, dental screening, eyesight test and for women breast cancer screening and cervical cancer screening. There is no empirical analysis with longitudinal data which has investigated the uptake of two different cardiovascular screening examinations such as the blood pressure check and cholesterol level check over a long time period. The cholesterol level check is implemented as an invitational programme The recommendations of both health check-ups are relevant for analysing the uptake of both screening examinations, because there is an increased likelihood of participating in screening examinations after the recommended time interval. For both screening examinations, a borderline level of the blood pressure or cholesterol level in the actual year can induce a follow-up control screening examination in the year. A conceptual theoretical framework for the empirical analysis is used which includes economic and non-economic factors
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