Rural–urban difference in the use of annual physical examination among seniors in Shandong, China: a cross-sectional study

Abstract

BackgroundRegular physical examination contributes to early detection and timely treatment, which is helpful in promoting healthy behaviors and preventing diseases. The objective of this study is to compare the annual physical examination (APE) use between rural and urban elderly in China.MethodsA total of 3,922 participants (60+) were randomly selected from three urban districts and three rural counties in Shandong Province, China, and were interviewed using a standardized questionnaire. We performed unadjusted and adjusted logistic regression models to examine the difference in the utilization of APE between rural and urban elderly. Two adjusted logistic regression models were employed to identify the factors associated with APE use in rural and urban seniors respectively.ResultsThe utilization rates of APE in rural and urban elderly are 37.4% and 76.2% respectively. Factors including education level, exercise, watching TV, and number of non-communicable chronic conditions, are associated with APE use both in rural and urban elderly. Hospitalization, self-reported economic status, and health insurance are found to be significant (p < 0.05) predictors for APE use in rural elderly. Elderly covered by Urban Resident Basic Medical Insurance (URBMI) (p < 0.05, OR = 1.874) are more likely to use APE in urban areas.ConclusionsThere is a big difference in APE utilization between rural and urban elderly. Interventions targeting identified at-risk subgroups, especially for those rural elderly, are essential to reduce such a gap. To improve health literacy might be helpful to increase the utilization rate of APE among the elderly.

Physical examination service utilization among seasonal immigrants in Sanya, China: a cross-sectional study

“…In this study we found only 26.80% seasonal immigrants received PE. This prevalence is much lower than previous studies by Ge DD et al (76.20%) 21 and Sun X et al (63.50%) 20 . Some reasons may explain this result.…”

“…Unexpected, not like other study 21,36,37 ,we found these without health insurance rather than those with health insurance (UEBMI: AOR = 0.59, p = 0.015; URBMI:AOR = 0.49, p = 0.012), were more like to have PE. That may be related with the availability of local health service.…”

“…This is different from the previous studies, which reported the utilization rate of PE among urban residents was higher than residents in rural residents. 21,22 That maybe due to there are huge differences in health resources between city and country, but those seasonal immigrants use the same health resources in Sanya which reduced the impact from differences of medical resource between city and country 23 .…”

“…But there also have some studies got the contrary conclusion. Some studies found people with higher education will be more positive to have PE and high education mean high economic status and more active to search for PE 28,21 . People with high education also mean they may have a high awareness of self-care, they could use more way to find self-health status like smart phone, family doctor which could decrease the frequency of going to the hospital for PE.…”

“…Xi Sun found above 65.50% people aged 60 or over in rural China taking annual physical examinations 20 . Another study found the utilization rate of annual physical examinations in urban elderly is 76.20% in Shandong Province and residents with basic health insurance are more likely to use PE 21 . However, most studies focused on long-term residents, there are almost no studies about the use of PE among the group of seasonal immigrants.…”