Factors Associated with Non-attendance at a Follow-up Visit for Dyslipidemia Identified at Health Checkups: A Retrospective Cohort Study in a Japanese Prefecture.

Abstract

Introduction: Dyslipidemia increases the risk of cardiovascular and cerebrovascular diseases. Visiting a physician for follow-up is essential when dyslipidemia is detected during health checkups. We investigated factors associated with non-attendance at a follow-up visit for dyslipidemia.

Methods: We conducted a retrospective cohort study using linked health checkups and medical claims data from individuals covered by National Health Insurance in Ibaraki Prefecture, Japan. Participants were 40-74 years old, underwent health checkups between April 2018 and March 2019, and had cholesterol levels exceeding the recommended levels to visit a physician. We excluded individuals who had visited physicians for dyslipidemia in the past year. We calculated the proportion of patients who had a follow-up visit with a physician within 180 days after their health checkup. Then, we investigated the demographic and clinical characteristics associated with non-attendance using a multivariable logistic regression model.

Results: Among 33,503 individuals (median age, 66 years [interquartile range, 59-69 years]; females, 58.8%) with dyslipidemia at the health checkup, 18.1% attended follow-up visits. Younger age, male sex, drinking habits, and lack of symptoms were associated with higher odds of non-attendance. Participants who underwent health checkups at public facilities, lacked other abnormal results at health checkups, and had not visited physicians for other diseases were less likely to attend a follow-up visit. Among those with elevated low-density lipoprotein cholesterol (LDL-C) levels, those with relatively lower LDL-C levels were less likely to attend.

Conclusions: Systems that inform high-risk populations of non-attendance and encourage follow-up visits are warranted.