札幌市における基本健康診査受診と国民健康保険医療費の関連性についての断面研究

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We assessed the relationship between participation in basic health check-ups and the cost of medical expenditure (CME) in the National Health Insurance (NHI) of Sapporo, Japan. The CME in fiscal year 2004, was calculated for each of the 115,966 participants in the basic health check-ups the same year, which as 37.2% of the citizens aged 40 years or over who were covered with the NHI. Moreover, the CME in fiscal year 2004 was also calculated for each of the 28,105 non-participants in the basic health check-ups of the same year who were randomly selected from the residual 62.8% of citizens aged 40 years or over covered with the NHI. Then, through record linkage using identification numbers of the NHI, the CME was calculated according to results of blood chemical tests or other measurements among the participants in the basic health check-up. An analysis of covariance was performed to compare age-adjusted means among the different groups by sex. As a result, the mean CME in the participant group was twice as high as that in the non-participant group. The proportion of experience in attending medical institutions as an outpatient and/or inpatient in the same year was significantly lower in the participant group than that in the non-participant group. The mean CME in ex-smokers was significantly higher than that in non-smokers. The mean CME in lean or obese citizens was significantly higher than that in citizens with normal obesity. Likewise, the mean CMEs in citizens with abnormally high blood sugar as well as abnormally low HDL-cholesterol were significantly higher than those in citizens within normal range of these results. However, a part of the mean CMEs in citizens with either abnormally high blood pressure or abnormally high triglyceride levels were not significantly different with those in citizens within normal range of these results. In conclusion, participation in the health check-up may be associated with low CME through a direct and/or indirect pathway, although it is difficult to infer a causal association with a cross-sectional study.
札幌医科大学の論文
2007-06-01

札幌市における基本健康診査受診と国民健康保険医療費の関連性についての断面研究

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