Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008

OBJECTIVES To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK. DESIGN Individual-level analysis of repeated cross-sectional surveys with balanced panel data. SETTING The UK. PARTICIPANTS Individuals taking part in the British Household Panel Survey (BHPS), 1992-2008. OUTCOME MEASURE Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests. METHODS Dynamic panel data models (random effects panel probit with initial conditions). RESULTS Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening. CONCLUSIONS Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention. TRIAL REGISTRATION This observational study was not registered.