A longitudinal study for the effectiveness of having specific health checkups on subsequent medical care expenditure reductions

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K10502
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Kochi University
• Principal Investigator: Yasuda Nobufumi 高知大学, 教育研究部医療学系連携医学部門, 教授 (30240899)
• Co-Investigator(Kenkyū-buntansha): 宮野 伊知郎 高知大学, 教育研究部医療学系連携医学部門, 准教授 (00437740)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 特定健康診査 / 医療費低廉効果 / 縦断研究 / 国民健康保険

Outline of Final Research Achievements

A longitudinal study examined the association between the frequency of having specific health checkups and subsequent medical care expenditures under the assumption that the effective duration of having a checkup is up to 12 months. The study materials during consecutive two or more years before the COVID-19 pandemic were obtained in two municipal national health insurances(N=2,801).
The expenditures of having checkups infrequently were higher than those of having checkups regularly, especially when medical care expenditures were restricted to those for lifestyle-related diseases. A major concern about this finding is a reverse causation: persons who skip checkups might do so because they have prevalent medical conditions. Further studies should explore effects of having irregular checkups on subsequent medical care expenditures.

Free Research Field

公衆衛生学

Academic Significance and Societal Importance of the Research Achievements

健診受診の医療費適正化効果は、健診を定期受診する場合に限られ、健診の不定期受診には効果がないことが示唆された。ただし、医療による管理を受けている生活習慣病を持つ者が健診を不定期にしか受診しないという、因果の逆転によって生じた結果とも考えられる。この問題に対処するために、健診受診時に治療中の生活習慣病を有する者を除いた上で、健診受診頻度別に医療給付の状況を観察する縦断研究が必要である。しかし、健診受診者での生活習慣病の有病率は高いので、規模が小さな集団では十分な人数の解析適格者が得られない。複数の地域が参加する大規模な縦断研究として実施する必要がある。