Development of evaluation indicators for general health screening institutions to enhance follow-up care

Objectives: To develop new evaluation indicators for general health screening institutions to enhance follow-up care. Methods: First, a two-level logistic regression was conducted to identify institutional factors associated with follow-up care. The study population included individuals newly identified as suspected cases of any of the seven target diseases through general health screening in 2022 and 2023. Second, new evaluation indicators were developed and tested through 16 simulations using fourth-cycle evaluation data. Results: Compared with institutions without relevant clinical specialties, institutions with relevant clinical specialties had higher odds of follow-up care for hypertension (OR=1.28), diabetes (OR=1.39), and dyslipidemia (OR=1.47). Compared with hospitals, clinics had higher odds of follow-up care for hypertension (OR=1.31), diabetes (OR=1.59), and dyslipidemia (OR=1.51). Health screening specialized clinics (HSSCs) also had higher odds of follow-up care for hypertension (OR=1.46) and diabetes (OR=1.13), but lower odds for dyslipidemia (OR=0.91). A set of scoring criteria and weights for the new indicators was proposed based on the results of 16 simulations, considering both acceptability and the discriminatory power of the evaluation system. Conclusion: The new evaluation indicators, reflecting institutional factors associated with follow-up care, may help strengthen follow-up care by incorporating these factors into the institutional evaluation system.