Effectiveness of an Out-of-Pocket Cost Removal Intervention on Health Check Attendance in Japan

Unseen Threats of Chronic Diseases among the Middle-Aged: Examining the Feasibility of Well-Defined Healthcare Vouchers in Encouraging Uptake of General Checkups

Background: The ageing population and the emergence of chronic diseases continue to pose immense challenges to the healthcare system. This study aims to explore how likely middle-aged citizens could be encouraged to attend health checkups by well-defined healthcare vouchers, and to explore potential factors associated with the uptake of health checkups. Methods: A cross-sectional survey with self-administered structured questionnaires was conducted among Hong Kong residents aged 45-59. The questionnaire consisted of 25 items, including attitudes toward healthcare vouchers and checkups, utilisation patterns of healthcare services, and socio-demographics. Results: We received 278 responses between June and September 2021. Among the study participants, 62.6% (174) attended regular checkups currently, and a total of 252 (90.6%) indicated that it was likely for them to undertake health checkups with well-defined vouchers. This proportion showed an increase of 44.8% after introducing vouchers (78 of 174) when compared with the proportion currently attending regular health checkups. Multiple logistic regression analysis revealed that the perceived barrier of health checkup uptake included financial cost (AOR 0.367, 95% CI 0.162-0.832, p = 0.016), whilst the government's recommendation (AOR 1.685, 95% CI 1.052-2.698, p = 0.030) and full support by the employer-purchased insurance (AOR 2.395, 95% CI 1.036-5.523, p = 0.041) were positively associated with uptakes. Conclusions: Financial cost is a significant barrier to health promotion and disease prevention. Well-defined vouchers, as a demand-side financial tool, were widely accepted by our participants as incentives to undergo health checkups. Our findings indicate that the voucher scheme could be extended to individuals aged 45-59 for health checkups by easing the financial barrier, and show the importance of involving government recommendations and employer-purchased insurance.