Nationwide periodic health examinations promote early treatment of hypertension, diabetes and hyperlipidemia in adults: Experience from Taiwan

Abstract

To investigate the effectiveness of nationwide periodic health examinations in promoting early treatment of hypertension, diabetes and hyperlipidemia in adults aged ≥40 years. Seven-year, retrospective, cohort study. Based on a large and representative claims dataset in Taiwan, cohort analysis was undertaken among three disease-free cohorts for hypertension, diabetes and hyperlipidemia (n = 26,661, 29,872 and 30,712 subjects, respectively) in 2000. Each cohort was observed from January 2001 to December 2007. Logistic regression, Cox proportional hazards analysis and the extended Cox model with counting process were employed in data analysis. Covariates such as age, gender, level of premium, beneficiary category, comorbidities and geographic factors were adjusted at baseline. For the hypertension, diabetes and hyperlipidemia cohorts, those who had ever used the preventive service between 1998 and 2000 had higher probabilities of being treated as new patients for these target diseases; the hazard ratios were 1.65, 1.32 and 1.57, respectively. Using the extended Cox model, associations for use of each service with treatment within a 1-year follow-up period between 2001 and 2007 were 1.68, 2.41 and 3.48. In adults who were initially disease-free, those who used the preventive service had higher probabilities of early treatment of these target diseases. These findings indicate the effectiveness of nationwide periodic health examinations.