Response to Yuan’s Capsule Commentary

We are very grateful to Yuan1 for her insightful comments on our recent study that examined ethnic differences in participation in medical check-ups among the elderly.2 Sociodemographic factors were taken into account in our study. Yuan1 alluded to our findings that health factors, such as presence of diabetes, hypercholesterolemia, and hypertension could influence an individual’s decision to participate in medical check-ups. Furthermore, Yuan1 suggested that the access to health care services, perception, and knowledge of health, as well as other social, personal, and community factors listed in the Andersen’s Behavioral Model, should also be included as the factors analyzed in our study.

In our view, Yuan1 has made a very important point, but some observations are in order. The impacts of health factors on participation in medical check-ups are unable to be analyzed without considering the level of health awareness of individuals. This is because medical check-ups are routine for individuals who are diagnosed with diabetes, hypercholesterolemia, or hypertension, and they would participate in medical check-ups even they have poor health awareness. In order to overcome this limitation, respondents with diabetes, hypercholesterolemia, or hypertension should be removed from the sample. Moreover, access to health care services and knowledge of health factors may be highly correlated with household location and educational level variables. Therefore, a multicollinearity test should be conducted prior to including these factors in the regressions.

Inclusion of the factors suggested by Yuan1 is not very difficult if data is available. Owing to the paucity of such data, the findings of our study remain useful for identifying the ethnic groups that need attention for policy purposes. The consideration of more variables in a future study, health variables, and others will certainly add to the knowledge on characteristics of individuals who participate and those who do not in medical check-ups.


  1. 1.

    Yuan Y. Capsule commentary on Cheah et al., Ethnic differences in participation in medical check-ups among the elderly: Evidence from Malaysia. J Gen Intern Med. 2020.

  2. 2.

    Cheah YK, Meltzer D. Ethnic differences in participation in medical check-ups among the elderly: Evidence from Malaysia. J Gen Intern Med 2020.

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Correspondence to Yong Kang Cheah PhD.

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Cheah, Y.K., Meltzer, D. Response to Yuan’s Capsule Commentary. J GEN INTERN MED (2021).

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