Baseline participation in a health examination survey of the population 65 years and older: who is missed and why?
BMC Geriatrics, January 2016
Beate Gaertner, Ina Seitz, Judith Fuchs, Markus A. Busch, Martin Holzhausen, Peter Martus, Christa Scheidt-Nave
Public health monitoring depends on valid health and disability estimates in the population 65+ years. This is hampered by high non-participation rates in this age group. There is limited insight into size and direction of potential baseline selection bias. We analyzed baseline non-participation in a register-based random sample of 1481 inner-city residents 65+ years, invited to a health examination survey according to demographics available for the entire sample, self-report information as available and reasons for non-participation. One year after recruitment, non-responders were revisited to assess their reasons. Five groups defined by participation status were differentiated: participants (N = 299), persons who had died or moved (N = 173), those who declined participation, but answered a short questionnaire (N = 384), those who declined participation and the short questionnaire (N = 324), and non-responders (N = 301). The results confirm substantial baseline selection bias with significant underrepresentation of persons 85+ years, persons in residential care or from disadvantaged neighborhoods, with lower education, foreign citizenship, or lower health-related quality of life. Finally, reasons for non-participation could be identified for 78 % of all non-participants, including 183 non-responders. A diversity in health problems and barriers to participation exists among non-participants. Innovative study designs are needed for public health monitoring in aging populations.
|Members of the public||6||86%|
|Practitioners (doctors, other healthcare professionals)||1||14%|
|Readers by professional status||Count||As %|
|Student > Master||10||21%|
|Student > Ph. D. Student||8||17%|
|Student > Bachelor||3||6%|
|Student > Doctoral Student||2||4%|
|Readers by discipline||Count||As %|
|Medicine and Dentistry||13||28%|
|Nursing and Health Professions||3||6%|
|Arts and Humanities||2||4%|