BMC Geriatr. 2025 Nov 25;25(1):953. doi: 10.1186/s12877-025-06654-6.
ABSTRACT
BACKGROUND: Health check-ups have emerged as a promising tool for disease prevention and health improvement. China introduced a community-based program providing annual health check-ups and consultation services at no cost for seniors aged 65 and above. However, the program’s impact has not yet been evaluated. This study purposed to assess the impact of the free health check-up program for the elderly.
METHODS: We analysed a pooled cross-sectional data from the National Health Service Survey (Shandong) in 2013 and 2018, comprising 38,948 representative samples. The outpatient care utilization, inpatient care utilization, and the EuroQol-5 Dimension (EQ5D) score were used to assess the program’s effects on reducing medical use and improving health. A combined Difference-in-Difference and treatment-effect model were employed to assess the program’s impact, after balancing the differences between the 2013 and 2018 samples using Coarsened Exact Matching. Moreover, this study explored variations in impact between urban and rural areas, as well as potential mechanism of underlying policy effect.
RESULTS: The free health check-up program for the elderly was significantly associated with an increase in EQ5D score and a reduction in outpatient care and inpatient care utilization (P < 0.01). Furthermore, the impacts were differed between urban and rural areas. The implementation of the free health check-up program has a statistically significant negative impact on the inpatient care utilization(P < 0.1) and positive impact on EQ5D scores (P < 0.05) among rural elderly, while these impacts do not reach statistical significance for urban elderly. The results of mechanism analysis indicated that free health check-ups program assists elderly in improving health through reducing unhealthy behaviors, such as smoking and alcohol consumption.
CONCLUSION: The free health check-up program for the elderly was associated with a reduction in their medical use and an increase in their health, positioning it as a potential model for other countries grappling with an ageing populace. Despite free nature of the program, the increment in the health check-up utilization remains low among the elderly. Enhanced efforts to promote effective use and follow-up consultation are necessary.
PMID:41291448 | DOI:10.1186/s12877-025-06654-6
