Do Health Check-Ups for Seniors Improve Diagnosis and Management of Hypertension and Diabetes in China?

We estimate effects of a health check-up on non-communicable disease (NCD) diagnosis and management among Chinese adults aged 50 and older. Using five waves of the China Health and Retirement Longitudinal Study (CHARLS) spanning a period of 9 years and a fixed-effect instrumental variable (IV) framework, we exploit a policy that provided free health check-ups for those 65 and above as an IV for health check-ups to address the endogeneity between health check-ups and health characteristics. We estimate that a check-up increases the probability of diabetes diagnosis by 8.3 percentage points (p=0.042), particularly among females in rural areas (13.3 percentage points, p=0.063). However, there was no significant effect on hypertension diagnosis. Despite improving diabetes detection, check-ups do not significantly increase diabetes treatment, disease control, or provider recommendations. Similarly, while they increase health behavior recommendations for hypertension management –possibly because the policy helped integrate previously diagnosed individuals into formal care– this does not translate into improved hypertension control. These findings highlight the importance of health checkups in improving diagnosis for certain conditions but reveal critical gaps in follow-up care and disease management.