An effectiveness analysis periodic health examination among adults aged 65 abd older in Taiwan - A representative population-based study

Background: The effectiveness of Health Examination (HE) on disease prevention has been confirmed by studies from different countries. However, most of these studies were limited to data collected in a single year. Therefore, the aim of this research is to explore the effectiveness of regular HEs on health services utilization and mortality among the elderly in Taiwan. Method: Data of this retrospective cohort study were extracted from the National Health Insurance claims data of a nationally representative sample of older adults aged 65 or over from 2009 through 2011. Participants were divided into: (1) never had HE; (2) received HE 1 to 2 times over the 3 years; and (3) received a HE annually in all the 3 years. Propensity score matching method was used to increase the comparability. Logistic and negative binomial regression models were used to compare the risk of mortality, outpatient visits, and hospitalization across the 3 groups. Results: Only 26.4% of the 82,309 older adults aged 65 or over received HE for all the three years and 55.4% of them never had HE. The elderly who received HE in all 3 years were 88% more likely to use outpatient services, but they were 2% less likely to be admitted to hospitals and 88% less likely to die, when compared with the elderly who never received HE over the three-year period. Conclusion: Slightly over a quarter of older Taiwanese had annual HE. A regular HE was associated with higher outpatient use, lower all-cause mortality and less hospitalization.