Factors in Health Examination Rate Among Chinese Older Adults - China, 2013-2023.

Introduction: Health examinations are important components of primary prevention in older adults. This study aimed to assess temporal trends in health examinations in China and analyze the factors with their use. Methods: To this end, four rounds of nationally and provincially representative cross-sectional surveys were conducted. Overall, 180,455 adults aged ≥65 years were included in this study. Weighted health examination rates were calculated for the overall population and the subgroups. The Anderson model analysis framework was used to analyze the associated factors. Results: From 2013 to 2023, the health examination rate among older adults aged ≥65 years within 1 year increased from 21.8% to 66.6%, corresponding to an annual increase of 5.6% and an average annual percentage change of 6.49%. Disparities across the subgroups diminished rapidly, particularly in terms of residence, location, education, and income. Examinations provided free of charge by the community accounted for the vast majority of the subgroups. Need- and health-related behavioral factors were the primary determinants. Conclusion: Over the past decade, substantial progress has been made in health examination rates for older adults, particularly among socially and economically disadvantaged populations. Further sustained policy and financial support should be implemented to achieve the universal coverage target for health examinations among older adults aged ≥65 years as defined by the Healthy China Initiative (2019-2030).