Provincial screening rates for chronic diseases of lifestyle, cancers and HIV in a health-insured population
Objective. To examine screening rates for chronic diseases of lifestyle (CDL), HIV and cancer in a privately insured population for a single insurer across all nine provinces in South Africa, and to determine whether or not there are any differences between the provinces.
Method. Screening rates were calculated as the proportion of eligible members who had received screening tests during 2011 in each province. Mean screening rates were compared between Gauteng and the other eight provinces.
Results. Nationwide screening rates were 20.5% for CDL, 8.2% for HIV and 31.9% for cancer. Despite similar insurance coverage, screening rates ranged from 0.3% to 0.95% lower in other provinces compared with Gauteng. Of all the provinces, Gauteng had the highest annual screening rates for CDL, breast cancer, prostate cancer and HIV (p<0.001), while the Western Cape had the highest rate for cervical cancer (p<0.001).
Conclusion. There is much variation in preventive care utilisation across the provinces within this health-insured population. Provinces with more abundant healthcare resources have higher screening rates. Further research is required to understand the reasons for the variation, given equal payment access.
Leegale Adonis, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
Ruopeng An, RAND Corporation, 1776 Main Street, Santa Monica, California
John Luiz, Graduate School of Business, University of Cape Town
Ateev Mehrotra, RAND Corporation, 1776 Main Street, Santa Monica, California
Deepak Patel, Discovery Vitality, 3 Alice Road, Sandton, Johannesburg
Debashish Basu, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
Roland Sturm, RAND Corporation, 1776 Main Street, Santa Monica, California
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Date published: 2013-03-18
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