Research

Provincial screening rates for chronic diseases of lifestyle, cancers and HIV in a health-insured population

Leegale Adonis, Ruopeng An, John Luiz, Ateev Mehrotra, Deepak Patel, Debashish Basu, Roland Sturm

Abstract


Background. Screening for asymptomatic diseases can reduce the burden of morbidity and mortality in all population groups. There is widespread geographical variation in the quality of care. Few data are available on national screening rates in South Africa and how these vary across the provinces.

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.

Authors' affiliations

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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Keywords

Chronic Disease of Lifestyle; Cancers; HIV; Screening

Cite this article

South African Medical Journal 2013;103(5):309-312. DOI:10.7196/SAMJ.6686

Article History

Date submitted: 2013-01-10
Date published: 2013-03-18

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