Korean J Fam Pract 2019; 9(4): 366-372  https://doi.org/10.21215/kjfp.2019.9.4.366
Influence of National Health Screening Program on All-Cause Mortality in Korea Analysis of the Korean Longitudinal Study of Aging, 2006-2014
Joo Young Lee, Sung Hi Kim*, Geon Ho Lee, Yun-A Kim, Eun Ryeong Jun, Min Jeong Ju
Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
Sung Hi Kim
Tel: +82-53-650-4247, Fax: +82-53-650-4242
E-mail: khmksh@cu.ac.kr
ORCID: http://orcid.org/0000-0002-4131-153X
Received: August 10, 2018; Revised: June 13, 2019; Accepted: July 17, 2019; Published online: August 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: To investigate the impact of national health screening on all-cause mortality risk, aged over 45.
Methods: Data from Korean Longitudinal Study of Aging 2006–2014 were assessed. A total of 10,254 participants were included at baseline, and survival rate was assessed biennially. Using cox proportional hazards model, the effect of health screening on mortality risk was investigated. Covariates were gender, depression, education, marital status, co-habitants, house income, social engagement, economic satisfaction, private health insurance, residence location, chronic diseases, and health behaviors (smoking, alcohol intake, regular exercise).
Results: At baseline 2006, 54.4% of participants didn’t undergo health screening. A hazard ratio (HR) for mortality risk of non-participants were 1.36 (95% confidence interval [CI], 1.21–1.53) after adjusting age and gender. Adding marital status and co-habitants to model 1 as covariates, HR was 1.34 (95% CI, 1.18–1.50) (model 2). Adding depression scores and socioeconomic vulnerabilities to model 2, HR was 1.29 s (95% CI, 1.14–1.45) (model 3). Adding chronic diseases to model 3, HR was 1.26 (95% CI, 1.14–1.48) (model 4). Finally, health behaviors have been added to model 4, HR was 1.24 (95% CI, 1.10–1.40) (model 5). In addition, the mortality risk increased as the cumulative number of missing health screenig increased accordingly.
Conclusion: Health screening was an independent factor to reduce mortality risk. Therefore, active encouragement to participate the health screening should be implemented to reduce all-cause mortality.
Keywords: Health Screening; All-Cause Mortality; Cox Proportional Hazard Model
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