Patterns of attendance to health checks in a municipality setting: the Danish ‘Check Your Health Preventive Program’ ^☆

Translated abstract

We aimed to investigate the determinants of attendance to a preventive health check program and to explore the homogeneity of the attenders.

4853 eligible persons living in the municipality of Randers, Denmark, from 2012 to 2013, aged 30–49 years, received an invitation to attend the ‘Check Your Health Preventive Program’. Data was obtained from the Danish National Registers. Socio-demographic factors, use of preventive services, morbidity were examined as determinants of attendance by Poisson regression analyses. A chi-squared automatic interaction detection decision tree analysis was used to identify mutually exclusive groups.

In total, 55% of the invited population attended (49% men). Attenders were more likely to be: of higher age; immigrants; cohabiting; have: higher socio-economic status; higher use of preventive services and lower morbidity. Decision tree analysis revealed six groups, with the most important variable being income: 1) low income, low education (A = attendance rate: 38%; P = population size: 11%); 2) low income, education higher than 10 years, living alone (A: 41%; P: 5%); 3) low income, education higher than 10 years, cohabiting (A: 56%; P: 16%); 4) middle income (A: 60%; P: 34%); 5) high income, living alone (A: 56%; P: 4%); 6) high income, cohabiting (A: 69%; P: 30%).

More than half of a general population voluntarily attended a general health check, despite a resource intensive offer. People with low resources had lower attendance rates. This study adds a detailed description of mutually exclusive groups of attenders, for use in future planning and implementation of preventive actions.

Highlights

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  Attendance was determined by socio-demographic factors and preventive services use.

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  Morbidity and medication purchase was associated with lower attendance rate.

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  Decision tree analysis revealed six groups of attenders.

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  Groups with low income, educational level, living alone, had lower attendance rate.

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  Targeted recruitment strategies should be considered as a way to increase attendance.