Annual Physical Examinations and Wellness Visits: Translating Guidelines into Practice

Social Capital from Online Social Media is Associated with Visiting a Healthcare Practitioner at Least Once a Year Among College Students

: Social capital is positively associated with healthcare access such as healthcare practitioner visits. There does not appear to be any literature on social capital through online social media and its association with healthcare access such as healthcare practitioner visits. This paper studies the relationship between social capital through online social media use and healthcare practitioner visits. Methods: Data were analyzed from 663 participants in New York City in 2017 with exposure to social media prescription medication advertisements from social media (e.g., Facebook, Twitter, LinkedIn, Instagram, YouTube). The main predictor variable was visiting a healthcare practitioner at least once a year. Outcome variables were bonding social capital and bridging social capital from online social media. Results: Those who visited a healthcare practitioner at least once a year had greater mean bonding social capital and bridging social capital from online social media than those who did not visit a healthcare practitioner at least once a year. Multivariate linear regression analyses showed a similar pattern for not visiting a healthcare practitioner at least once a year (bonding social capital: b=-5.31, SE=1.68, p=0.002; bridging social capital: b=-3.27, SE=1.55, p=0.04). Conclusions: Government organizations, healthcare practitioners, and healthcare organizations should continue marketing and disseminating health education for young adults through online social media. This public health online social media health education is likely to be considered bonding social capital and/or bridging social capital by young adults and this may be associated with more young adults visiting healthcare practitioners at least once a year.

Cognition, attitude, practice toward health checkup and associated factors among urban residents in southwest China, Sichuan province, 2022: a community-based study

Aim

Research on the health checkup status of urban residents in Southwest China is limited. In this study, we aimed to investigate the current status of health checkups and explore their influencing factors by analyzing the cognition, attitudes, and practices of urban residents in Southwest China.

Methods

We sampled 1200 urban residents for a questionnaire survey. Statistical analysis was performed using SPSS 23, and logistic regression analysis was used to analyze the factors affecting cognition, attitudes, and practices regarding health checkups. A P value < 0.05 was used to identify variables significantly associated with the outcome variable.

Results

Overall, 29% of the residents understood the importance of health checkups. The main ways urban residents acquire health-related knowledge are through the use of mobile media and medical staff health education. Only 40% of residents had undergone a regular checkup. Health self-assessment, economic reasons, and time are the factors that interfere with urban residents' health checkups. Logistic regression analysis showed that occupation status, educational background, self-assessed health status, exercise status, and monthly income level were the common influencing factors of health checkup cognition and planning. Whether residents had participated in a medical checkup program was also related to sex and age.

Conclusions

Urban residents in Southwest China generally had a high willingness to undergo physical examinations, but there were differences in knowledge and practice; at the same time, residents lacked understanding of respiratory assessments. Improving the health literacy of medical staff, strengthening urban residents' health education, and enhancing the utilization rate of health checkups in urban residents are necessary and urgent.

Does financial literacy influence preventive health check-up behavior in Japan? a cross-sectional study

Background

General health check-ups are an important element of healthcare, as they are designed to detect diseases, thereby reducing morbidity and mortality. Recent studies have found that financial literacy promotes preventive healthcare usage and reduces risky health behaviors such as smoking, lack of exercise, and gambling. Based on this evidence, we hypothesize that financial literacy, as a rational decision-making tool, is positively associated with health check-up behavior in Japan.

Methods

We extracted data on financial literacy, the main explanatory variable of this study, from the 2010 wave of the Preference Parameter Study (PPS) of Osaka University. Data on health check-up behavior as a dependent variable, along with control variables, were obtained from the 2011 PPS wave. Our sample focused on Japan’s middle-aged working population (40–64 years), and we applied probit regressions to test our hypothesis.

Results

Our final sample size was 2,208 participants after merging the two datasets. Descriptive statistics show that respondents had moderate financial literacy (mean = 0.62, SD = 0.33), low financial education (mean = 0.17, SD = 0.38), and low participation (mean = 31.75%, SD = 46.56%) in the health check-up. The probit regression analysis showed that financial literacy is insignificantly associated with health check-up behavior in Japan (coefficient = -0.0229; 95% CI: -0.2011—0.1551; p-value = 0.801). However, demographic factors such as being male (coefficient = -0.2299; 95% CI: -0.3649—-0.0950; p-value = 0.001), older (coefficient = 0.0280; 95% CI: 0.0188 – 0.0371; p-value = 0.000), and married (coefficient = 0.3217; 95% CI: 0.0728 – 0.5705; p-value = 0.011), as well as risky health behavior such as smoking (coefficient = -0.2784; 95% CI: -0.4262—-0.1305; p-value = 0.000) are significantly related to health check-up behavior.

Conclusions

Our results suggest that financial literacy insignificantly motivates people to behave rationally and understand the value of health check-ups as a tool for sustainable health.

An Ultrasound Screening Exam During Medicare Wellness Visits May Be Beneficial

OBJECTIVES

The physical exam component of a periodic health visit in the elderly has not been considered useful. Standard Medicare Wellness visits require no physical exam beyond blood pressure and most physicians perform limited exams during these visits. The objective of this study was to test the feasibility, potential benefit, and costs of performing a screening ultrasound (US) exam during Medicare Wellness visits.

METHODS

A physician examiner at an academic internal medicine primary care clinic performed a screening US exam targeting important abnormalities of patients 65-85 years old during a Medicare Wellness visit. The primary care physician (PCP) recorded the follow-up items for each abnormality identified by the US examiner and assessed the benefit of each abnormality for the participant. Abnormality benefit, net exam benefit per participant, follow-up items and costs, participant survey results, and exam duration were assessed.

RESULTS

Participants numbered 108. Total abnormalities numbered 283 and new diagnoses were 172. Positive benefit scores were assigned to 38.8%, neutral (zero) scores to 59.4%, and negative benefit scores to 1.8% of abnormalities. Net benefit scores per participant were positive in 63.9%, 0 in 34.3%, and negative in 1.8%. Follow-up items were infrequent resulting in 76% of participants without follow-up cost. Participant survey showed excellent acceptance of the exam.

CONCLUSIONS

The US screening exam identified frequent abnormalities in Medicare Wellness patients. The assessed benefits were rarely negative and often mild to moderately positive, with important new chronic conditions identified. Follow-up costs were low when the PCPs were also US experts.

Does health literacy affect the uptake of annual physical check-ups?: Results from the 2017 US health information national trends survey

Background

Little is known about how health literacy is linked to physical check-ups. This study aimed to examine the levels of physical check-ups (self-reported check-ups within the last year) by age group (those aged 18–59 years and those aged = ≥ 60 years) and the role of health literacy regarding physical check-ups in the United States.

Methods

Data for the study were obtained from the 2017 Health Information National Trends Survey. The original sample included 3,285 respondents, but only 3,146 surveys were used for this study. Andersen’s Behavioral Model of Health Services Use guided this study, and a binomial logistic regression model was conducted using Stata 12.0 software package.

Results

While 82.0 % of the older group had an annual check-up, 67.3 % of the younger group had one. Both groups had similar ratios for health literacy-related item reporting. Study results show that annual check-up was positively associated with confidence in getting health information, having health insurance, and having a primary doctor for both age groups. However, getting a regular check-up was negatively associated with frustration while searching for information among the younger group. In comparison, it was positively associated with difficulty understanding information for the older group.

Conclusions

To increase annual physical check-ups, health literacy-related interventions should be developed and address the barriers most associated with health check-ups. One way of addressing this barrier is to improve communication from healthcare professionals to consumers through the use of easy-to-understand explanations appropriate for the consumer.

Predictors of Receipt of Clinical Preventive Services in Adolescents and Adults with Down Syndrome Accessing Medicaid

BACKGROUND

Persons with Down syndrome (DS) require preventive care that addresses their age-/gender- and syndrome-specific needs. Yet, adolescents and adults with DS do not receive these preventive care services as recommended.

OBJECTIVE/HYPOTHESIS

To identify factors that predict receipt of age-/gender- and syndrome-specific preventive healthcare among adolescents and adults with DS. We hypothesized that more healthcare encounters and greater medical complexity would increase receipt of preventive care due to more opportunities to complete these activities.

METHODS

Using Medicaid claims (2006-2010) for California, Colorado, Michigan, and Pennsylvania, we conducted a retrospective cohort study of adolescents and adults with DS (≥12 years old). We modeled receipt of both ≥1 wellness examination and ≥1 thyroid function test (TFT) in 2009-2010 as a function of receipt of those same healthcare activities in 2006-08, adjusting for demographics, key comorbidities, and medical complexity using multivariable logistic regression.

RESULTS

In this cohort of 3487 adolescents and adults with DS accessing Medicaid, 17% received both ≥1 wellness examination and ≥1 TFT in 2006-2008, 15% in 2009-2010, and only 7% during both time periods. Despite medical complexity and frequent healthcare interactions, the best predictor of future receipt of these activities was past receipt. State of residence variably impacted receipt of these preventive activities.

CONCLUSIONS

Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.

A Primary Care Prevention System for Behavioral Health: The Behavioral Health Annual Wellness Checkup

Behavioral health problems are involved in the majority of primary care visits. These behavior disorders (e.g., depression, anxiety, smoking, insomnia, etc.) are costly, burdensome to both the patient and the healthcare system, and result in greater medical utilization/cost and poorer future health outcomes. Integrated behavioral healthcare has been proposed as a model for more efficiently addressing the burden of behavioral health problems. While this model has demonstrated some promise in the treatment of behavioral health problems, as well as in the reduction in costs and improvement in healthcare outcomes, the primary prevention of behavioral health problems in this delivery model has been relatively neglected. The present paper discusses the potential value of incorporating the prevention of behavioral health problems into the annual physical/wellness checkup and proposes a detailed system for how this might be accomplished. Limitations, future research, and costs associated with increased prevention in a primary care context are discussed.

Comparing Smoking Cessation Outcomes in Nurse-Led and Physician-Led Primary Care Visits

Smoking is a significant public health concern in the United States, yet 50% of patients do not receive recommended tobacco use screening and counseling. This project compared smoking cessation rates in newly reimbursable nurse-led wellness visits with rates in physician-led visits. Although the findings were not statistically significant, they suggested that smoking cessation is at least equivalent in patients who attend nurse-led visits compared with physician-led visits and may be higher.